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NON PROFIT PROFESSIONAL LIABILITY POLICY <br /> RENEWAL CERTIFICATE <br /> Please attach this Renewal Certificate to your expiring Policy , <br /> UNITED STATES LIABILITY <br /> INSURANCE COMPANY <br /> WAYNE, PENNSYLVANIA <br /> In consideration of the renewal premium stated below, expiring Policy Number ND01005544E is renewed <br /> for the Policy Period stated below. The Company will issue a complete copy of this Policy upon receipt of <br /> a written request from the Insured . <br /> The New Policy Number is ND01005544F . <br /> The Application ( if any) for this renewal , and all previous Applications made to the Company for this <br /> insurance , including any material submitted therewith , shall be made a part of this Renewal Policy as if <br /> physically attached hereto . PLEASE REFER TO YOUR POLICY FOR THE DEFINITION OF <br /> "APPLICATION . " <br /> POLICY DECLARATIONS <br /> ITEM I . PARENT ORGANIZATION AND PRINCIPAL <br /> Indian River County Healthy Start Coalition , Inc. <br /> 160310th Avenue <br /> Vero Beach, FL 32960 <br /> ITEM ll . POLICY PERIOD : (MM/DD/YYYY) 12 :01 AM STANDARD TIME AT <br /> FROM 8/8/2004 TO 8/8/2005 YOUR MAILING ADDRESS SHOWN <br /> THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH LIMITS OF LIABILITY ARE INDICATED. <br /> Coverage Part A . Non Profit Directors and Officers Liability <br /> ITEM 111 , LIMITS OF LIABILITY: $ 1 , 000 , 000 EACH CLAIM <br /> Not Covered FIDUCIARY LIABILITY LIMIT <br /> $ 1 , 0000000 IN THE AGGREGATE <br /> ITEM IV. RETENTION : $ 0 EACH CLAIM <br /> ITEM V. PREMIUM : $ 1 , 218 <br /> Coverage Part B . Employment Practices Liability <br /> ITEM III , LIMITS OF LIABILITY: $ 1 , 000 , 000 EACH CLAIM <br /> $ 1 , 000 , 000 IN THE AGGREGATE <br /> ITEM IV. RETENTION : $ 0 EACH CLAIM <br /> ITEM V. PREMIUM : $ 343 <br /> ITEM VI . Coverage Forms Parts and Endorsements made a part of this policy at time of issue : <br /> DNOTIC ( 12-02) Discl. Notice of Terrorism Insurance Coverage USL-DOJ (04-00) Policy Jacket <br /> DO- 100 (04-00) Coverage . Part A <br /> DO- 101 (04-00) Coverage Part B <br /> DO-209 (01 -94) General Professional E & 0 Excl. Endt <br /> DO-273 (04-02) Fair Labor Standards Act, Exclusion <br /> DO-275 ( 11 -02) Coverage Clarification Endt <br /> DO-FL (07-01 ) Florida State Amendatory Endt <br /> Endorsements in bold have been added to the policy or have a new edition date and are attached with this certificate. <br /> Agent : AGENCY MARKETING SERVICES , INC . [1004] By <br /> Date Issued : 8/5/2004 <br /> Authorized Representativ <br /> USL-DOD CERT (11197) <br />