2004-229B (2) - Laserfiche WebLink

Home Browse Search

11 / 04 / 2004 14 : 42 7727704580 PAGE 01 e r, DATE. (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE I NOV 404 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SID BANACK INSJA H11.13 ROGAL & HOBBS CO, ONLY AND TIFICATE HOLDER. THIS NCERTIFICATE DOES NOT AMEND,FERS NO RIGHTS UPON THE EXTEND OR 204614TH AVE. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P 0 BOX 130 VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE I NAIC # --- •—•-- - - — '— — — ' -- - -' —' — INSURERA: AUTO-OWNERS INSURANC I— E COMPANY_ INSURED — -- INDIAN RIVER COUNTY HEALTHY START, INC. INSURER e: HARTFORD UNDERWRITERS INSURANCE COMPANY --- — — — 1603 10TH AVE, �--INSURER- -- VERO BEACH FL 32880 INSURER D. In. In INSURER E; COVERAGES THE POLICIES OF ISURANCE LSTED BELOW 14AVE BEEN ANY REQUIRE ENTNTERM OR CIONDIT ON OF ANY CONTRACT UOR OTHER ED TO THE (DOCUMENT WNSURED NITH RESPECT RES T To WHICH THIS AS VE FOR THE IPCERTIFICATEAMAp BE ISSUED OARNOING MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY NUMBER — • —• . . ..—. . .. • — ... . T • -" POLICY 9FFECTNe 1 POLICY EXPIRATION LIMITS TYPE OF INSURJWCE ( p LTR MJe EACH OCCURRENCE S 1 ,0000 0,0 GENERAL LIABILIY 93-211 -127-00 MAR 10 04 MAR 10 OS — — -- — --- r DAMAGE TO RENTED I j 50 ,000 I rX COMMERCIAL GENERAL LIABIUT i I [EREU g.eF. .+I .. _ - — _ MED. EXP (Any Cp4VZW) S 31000 I ' - I CLAIMS MADE X I OCCUR I II . ' I I-- I I PERSONAL 3 AW INJURY , i Included A I — - — - - In.. I I GENERAL AGGREGATE I S 1 ,0000000 _.. --- -- --• -.. :_. I I I PRODUCTS-COMP/OP AGG. ; Z 1 ,000 ,000 In I GEN'L AGGREGATE LIMIT APPLIES PERI I I . . . . .. . - In ,. . . In POLICY I i PR0 LOC' AUTOMOBILE LIABILITY I 93411 -12740 MAR 10 04 I MAR 10 05 4COMBINED SINGLE LIMIT I i 11000,000 I (EP mocldera) I I 1 ANY AUTOI . — _. ALL OWNED AUTOS _. _. I I BODILY INJURY I I I I (Per persa�) I S 1 I I) SCHEOULED AUTOS A I FX 1 HIRED AUTOS I I I I BODILY INJURY 1"X ] NON-0WNED AUTOS -•- - ' 1 PROPERTY DAMAGE is Per Par-wert GARAGE LIABILITY I AUTO ONLY • EA ACCIDENT 13 ANY AUTO I I I OTHER THAN EA ACC ' 3 - In _. I AUTO ONLY: $ i Arr EXCESSIUMBRELLA LIABILITY I EACH OCCURRENCE S y1 OCCUR -, CLAIMS MADE I I I AGGREGATE i5 ! s I . DEDUCT19LE I I h ! I $ RETENTION S WORKERS COMPENSATION AND 21WEC GD7700 MAY 3 04 MAY 3 06 _ ._I.Tt0BX MWC LTA . ; OTHER10 EMPLOYERS' LIABILITY I 1 E.L. EACH ACCIDENT 3 100, 000 ANY PROPRIETOIVPARTNERIEJIECVI'IVE . __ _ . . .__. . . . . . _ . . B I 0FFICER4MNM91t EXCLUDED? I I I I E.L. DISEASE-EA EMPLOYEE 13 1001000 N lay, dotrlEe andel00 I i •-- ' --._ . . _ .. ... .._... IMPCIAL PROVISIONS Wow E.L DISEASE-POLICY LIMIT is b00 ,0 ( OTHER: DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS ALSO NAMED AS AN ADDITIONAL INSURED WITH REGARDS TO COMMERCIAL GENERAL LIABILITY COVERAGE, ALSO NOTE 10 DAYS NOTICE OF CANCELLATION FOR NONPAYMENT OF PREMIUM CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON THE INDIAN RIVER COUNTY BOARD OF INSURER, ITS AGENTS OR REPRESENTATIVES. COUNTY COMMISSIONERS 1840 25TH ST AUTHORIZED REPRESENTATIVE VERO BEACH, FL 32960 j� n Pan „ Q P Attantlon : JOYCE JOHNSTOWCARLSON I IChele N . Poysell �✓e " ACORD 25 (2001 /08) Certificate # 81924 0 ACORD CORPORATION 1988