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A00 CERTIFICATE OF LIABILITY INSURANCE C DATE (mmrOD <br /> HIBISIS -2 10 / 05 / 06/ 06 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> R . V . Johnson { GSM } HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 2041 E Ocean Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Stuart FL 34996 <br /> Phone : 772 -287 - 3366 Fax : 772 -287 - 4255 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: National Indemnity Co . <br /> INSURER B. Markel International <br /> Hibiscus Childress Center Inc . ers Ins .INSURER C: Brid efield Employers fiHibiscus Childress Foundation g <br /> P Y <br /> P 0 BOX 305 INSURER D <br /> Jensen Beach FL 34958 <br /> INSURER E. <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSJi ADD I . <br /> LTR INSR TYPE OF INSURANCE POLICY NUMBER P EFfDD E DDfN N <br /> DATT Y E MFECTY DATE EXPIRATI LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 170001, 000 <br /> $ X COMMERCIAL GENERAL LIABILITY 3602SS255610 - 3 07 / 12 / 06 07 / 12 / 07 PREMISES (Ea occttrence) $ 2001000 <br /> CLAIMS MADE OCCUR MED EXP (Any one person) $ 15000 <br /> PERSONAL B ADV INJURY $ 11, 0001000 <br /> X ABUSE /MOLES $ IM/ $ GENERAL AGGREGATE $ 31 OOO , OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 31, 0001000 <br /> X POLICY JE° 7 LOC ! Emp Ben . $ 1M/ $ 3M <br /> AUTOMOBILE LIABILITY <br /> A X ANYAUTO BINDER #43766 07 / 12 / 06 07 / 12 / 07icOMBwEosINGLEUMIT . $ 1 , 000 , 000 <br /> (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> X HIREDAUTOS <br /> BODILY INJURY $ <br /> X NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> —,' ANY AUTO OTHEEAACC $ <br /> AUTO ON <br /> THAN <br /> ' <br /> AUTO ONLY: qGG $ <br /> EXCESSAIMBRELLA LIABILITY EACH OCCURRENCE 62 / 000 / 000 <br /> BIX OCCUR CLAIMSMADE 4602SS255623 -2 07 / 12 / 06 07 / 12 / 07 AGGREGATE s 2 / 000 / 000 <br /> ' 8 <br /> DEDUCTIBLE $ <br /> X RETENTION $ 10000 $ <br /> WORKERS COMPENSATION AND TORY LIMITS X UE R <br /> C EMP LOYERS' LIABB-RY 0830 - 28580 02 / 22 / 06 02 /22 / 07 E. L. EACHACCIDENT ! s500000 <br /> ANY PROPRIETOR/EXCLUDED?OFFICER/MEMBER EXCLUDED9 E . DISEASE - EA EMPLOYEE' $ 50 00 00 <br /> If yes, describe under <br /> I SPECIAL PROVISIONS below iDISEASE - POLICY LIMIT $ 500000 <br /> OTNER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> 30 days notice of cancellation for workers compensation coverage . <br /> Companies have the option to cancel 10 days for non-payment . Certificate <br /> holder is added as additional insured . <br /> CERTIFICATE HOLDER CANCELLATION <br /> INDIA02 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 * DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> Indian River County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> 1840 25th Street REPRESENTATIVES. <br /> Vero Beach FL 32960 AUTHO D PRESENTp]IVE <br /> ACORD 25 (2001108) ' © ACORD CORPORATION 1988 <br />