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11 / 04 / 2004 14 : 42 7727704580 PAGE 01 A. C DATE (OV 4DrrYYY) TM. CERTIFICATE OF LIABILITY INSURANCE Novao4 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SID SANACK INSJA Hil_8 ROGAL & HOBBS CO. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 04614TH AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2 2 0 BOX A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 30 VERO BEACH FL 32961 INSURERS AFFORDING COVERAGE I NAIC # INSURED INSURER A: AUTO-OWN COMPANY_ __ _.. _ - - -- — INDIAN RIVER COUNTY HEALTHY START, INC. ! INSURER B,. HARTFORD UNDERWRITERS INSURANCE COMPANY 1603 10TH AVE. INSURER C; VERO BEACH FL 32980 - ' - I INSURER D: —. ._.. . _.. .. . __ .. .. . ... _ . . _ INSURER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWNMAY HAVE BEEN REDUCED BY PAID CLAIMS. - _.. . .. . _ ... . . - - � . ... FFECTNI' rPO+JCY �.I� LIMITS TYPE OF INSURCE POLICY NUMBER LTR ANIMAMPMMp GENERAL LWBILITY 93-211127-00 MAR 10 04 MAR 10 05 I EACH OCCURRENCE__. , $ 1 ,000, 00 - I I t-DAMAGE To rErmo rt 50 ,000 �X COMMERCIAL GENERAL 11ABIL1� I ! - - - L - • ._ a r. EXP (Any one person) S 5,000 1 I CLAIMS MADE( X I OCCUR IPERSONALA ADV INJURY , i Included 1 A ! I . -� .. — • _ — - - I I GENERAL AGGREGATE � s 1 ,000,000 ! I I PRODUCTS-COMP1.OF AGG• ; _ 1 ,000,000 — .E IT APPLIES PER I _. GEN L AGGREGATE LIMIT _. . I POLICY I I PROLQci AUTOMOIMLE LIABILITY I 93-211 -127.00 i MAR 1004 I MAR 10 OSi COMBINED BII aEDSINGLE LIMIT I s 1 ,000,000 1 ANYAUTO I - -INJURY- ALL OWNED AUTOS I I BODILY I I I I (Per person) � s ' r 11I SCHEDULED AUTOS -•- • A FX I HIREDAUTOS I I I BODILY Dacddont)RY Is X I NON-OWNED AUTOS I {-•- - . I PROPERTY DAMAGE S PerooddeM GARAGE LIABILITY I I I AUTO ONLY - EA ACCIDENT I i I ANY AUTO I OTHER THAN EA ACC ' S -._ I AUTO ONLY: --- S — EXCESS I UMBRELLA LIABILITY I EACH OCCURRENCE - S I - �! OCCUR r -, CLAIMSMADE I I ( AGGREGATE IS L s . » DEDUCTIBLE ! I RETENTION S I s WORKERS COMPENSATION AND 21 WEC GD7700 MAY 3 04 MAY 3 06 (VVC $T� " U. ; °T"ea EMPLOYERS' LIABILITY B IAM/ PRGPRET0WPARTIIEFMXE1MVE I I I_E.L. EACH ACCIDENT -S 100,000 OFFICER MEIMMR EXCLUDED? I , E.L. DISEASE-EA EMPLOYEEI s 1001000 ._- . .-- spP.CtALPROVISION% W" I E.L, DISEASE-POLICYLMAIT Is 5001000 ( OTHER: DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/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 KIND UPON THE INDIAN RIVER COUNTY BOARD OF INSURER, ITS AGENTS OR REPRESENTATIVES. COUNTY COMMISSIONERS 184025TH ST AUTHORIZED REPRESENTATIVE f] Q Yoe" p VERO BEACH, FL 32960 d Yoe Attention : JOYCE JOHNSTON-CARLSON IChele N . Poysell ACORD 25 (2001 /08) Certificate # 81924 O ACORD CORPORATION 1988