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ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10 / 07 / 09 PRODUCER 1 - 305 - 592 - 6080 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J . Gallagher Risk Management Services , Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND , EXTEND OR 8200 N . W . 41st Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Suite 200 Miami , FL 33166 Antonio B . Abella - A000306 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: NATIONAL CATHOLIC RRG 10083 DIOCESE OF PALM BEACH CATHOLIC CHARITIES OF PALM BEACH , INC . INSURER B: UNDERWRITERS AT LLOYDS LONDON 15792 9995 N . MILITARY TRAIL INSURERC: PALM BEACH GARDEN , FL 33410 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 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . INSR ADDT POLICYEFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER LIMITS A GENERAL LIABILITY RRG105010 04 / 01 / 09 04 / 01 / 10 EACH OCCURRENCE $ 10000 , 000 AGE TO RENTED B X COMMERCIAL GENERAL LIABILITY J096260 04 / 01 / 09 04 / 01 / 10 PREMISES (Ea occurence $ Included CLAIMS MADE a OCCUR MED EXP (Any one person) $ Ni 1 PERSONAL & ADV INJURY $ 10000 , 000 GENERAL AGGREGATE $ 1 , 000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 1 , 000 , 000 POLICY F1 PRO LOC EC B AUTOMOBILE LIABILITY J096260 04 / 01 / 09 04 / 01 / 10 A X RRG105010 04 / 01 / 09 COMBINED SINGLE LIMIT $ 1 , 000 , 000 ANY AUTO 04 / 01 / 10 (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULEDAUTOS (Per person) $ X HIREDAUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTOONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR F] CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND J096260 04 / 01 / 09 04 / 01 / 10 X WCSTATU, OER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 5000000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500 , 000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500 , 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Wherever Insurer B is shown : $ 250 , 000 Self Insured Retention is included within the limits THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SOLELY WITH RESPECT TO THE GENERAL LIABILITY COVERAGE AS REQUIRED BY WRITTEN FOR LIABILITY ARISING OUT BY THE OPERATIONS OF THE NAMED INSURED IN CONNECTION WITH THE COUNTY FUNDING FOR THE SAMARITAN CENTER AT 3650 41TH STREET , VERO BEACH , FL 32967 , CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INDIAN RIVER COUNTY COMMISSIONERS DATE THEREOF, THE ISSUING INSURER 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 INSURER, ITS AGENTS OR 1801 27TH STREET REPRESENTATIVES. VERO BEACH , FL 32960 AUTHORIZED REPRESENTATIVE USA ACORD 25 (2001 /08) VIRGOM © ACORD CORPORATION 1988 13288252