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2009-251I
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2009-251I
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Last modified
3/15/2016 10:37:46 AM
Creation date
10/1/2015 12:55:27 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
09/22/2009
Control Number
2009-251I
Agenda Item Number
8.M.9
Entity Name
United Families Inc.
Subject
Foster Parent Retention Program Grant Contract
Children's Services Advisory Committee
Supplemental fields
SmeadsoftID
7892
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ACORD„ CERTIFICATE OF LIABILITY INSURANCE OP ID <br /> UNITE09 04 / 28 / 09 <br /> RODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIOF <br /> Irown & Brown of Florida , Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> ) aytona Beach Office HOLDER. THIS CERTIFICATE DOES NOT AMEND , EXTEND OR <br /> ) . 0 . Box 2412 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br /> Iaytona Beach FL 32115 - 2412 <br /> ?hone : 386 - 252 - 9601 Fax : 386 - 239 - 5729 INSURERS AFFORDING COVERAGE NAIC # <br /> 4SURED INSURER A: Diamond State Ins Co 42048 <br /> INSURER B: LLO d ' s of London <br /> UNITED FOR FAMILIES , INC . INSURER C: Philadelphia Ins Co 23850 <br /> DONNA ERRIFANIA <br /> 10570SOLUCIE DERAL HWY <br /> ST 300 INSURER D: Diamond State Ins Co 42048 <br /> PORT ST INSURER E: <br /> : OVERAGES <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 MAY BE 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 CLAIMS . <br /> TR NSR TYPE OF INSURANCE <br /> POLICY NUMBER DATE(M /DDEFFECTIVE PDATE ( MM%DD TION LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 2 , 000 , 0 0 0 <br /> A X COMMERCIAL GENERAL LIABILITY AGA0003596 03 / 15 / 09 03 / 15 / 10 PREMISES (Ea occurence) $ 100f00O <br /> CLAIMS MADE X❑ OCCUR MED EXP (Any one person) $ 10 , 000 <br /> PERSONAL & ADV INJURY $ 2 , 0 0 0 , 0 0 0 <br /> X PROF LIAB — $ 2 MM GENERAL AGGREGATE s 4 , OOO , OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4 , 000 , 000 <br /> X POLICY 7 <br /> PRO- <br /> JECT LOC Emp Berl , 1 , 000 , 000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> k ANY AUTO AGA0003596 03 / 15 / 09 03 / 15 / 10 (Ea accident) <br /> ALL OWNED AUTOS BODILY INJURY $ <br /> (Per person) <br /> SCHEDULED AUTOS <br /> X HIRED AUTOS BODILY INJURY $ 1 , 000 , 000 <br /> (Per accident) <br /> X NON-OWNED AUTOS <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY : AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR � CLAIMS MADE AGGREGATE $ <br /> $ <br /> $ <br /> DEDUCTIBLE <br /> RETENTION $ <br /> WORKERS COMPENSATION AND TORY LIMITS I I ER <br /> EMPLOYERS' LIABILITY E. L. EACH ACCIDENT $ <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? E. L. DISEASE - EA EMPLOYEE $ <br /> If yes, describe under E. L. DISEASE - POLICY LIMIT $ <br /> SPECIAL PROVISIONS below <br /> OTHER <br /> DIRECTOR & OFFICER PHSD406618 03 / 15 / 09 03 / 15 / 10 LIABILITY 3 , 000 , 000 <br /> CRIME 21BDDFD6907 03 / 15 / 09 03 / 15 / 10 SEE NOTES <br /> oESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> tTHIRTY DAYS NOTICE OF CANCELLATION , TEN DAYS NOTICE DUE TO NON- PAYMENT <br /> :RIME COVERAGE CONTINUED : EMPLOYEE DISHONESTY $ 25000 / $ 500 DEDUCTIBLE ; <br /> ?ORGERY OR ALTERATIONS $ 25000 / $ 250 DEDUCTIBLE ; THEFT , DISAPPEARANCE & <br /> )ESTRUCTION OUTSIDE THE PREMISE $ 25000 / $ 500 DEDUCTIBLE <br /> : ERTIFICATE HOLDER CANCELLATION <br /> UNITE 0 7 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 * DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> UNITED FOR FAMILIES , INC . REPRESENTATIVES. <br /> 10570 SOUTH FEDERAL HWY ST 300 <br /> PORT ST LUCIE FL 34952 <br /> kCORD 25 (2001 /08 ) © ACORD CORPORATION <br />
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