2004-229E (2) - Laserfiche WebLink

Home Browse Search

MRY- 18-2004 13 : 58 HARBOR INSURANCE AGENCY 772 460 2315 P . 07/ 12 OP ID DATE (MM/DI)NYYY) ACORD� CERTIFICATE OF LIABILITY INSURANCE EXCHA- 1 05 / 18 / 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HARBOR INSURANCE AGENCY HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 2122 Colonial Road , Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Fierce FTI 34950 - 5309 i _.�one : 772 - 461 - 6040 Fax : 772 - 460 - 2315 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Philadelphia lndemnity Ina Co The Exchange Club Center -l•• fo the Prevention of INSURER Hartford Ina CO of the Midwest Ch ld Abuse DBA " Exchange Club C . A . S . T . L . E . INSURER C: PO Box 12908 INSURER D: Ft Pierce FL 34979 - INSURER E: COVERAGES THE POLOES 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TUE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. �FMCYEFF15CT CYEXPIRA7I6 LTR N811TYPE OF INSURANCE POLICY NUMBER DATE (MMID DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1 , 000 , 000 DAMAGE 0R 0 A X X COMMERCIAL GENERAL LIABILITY FHPAO 714 3 4 03 / 26 / 04 03 / Z6 / 05 PREMISES (Ee occurenco) $ 100 , 00 CLAIMS MADE I X I OCCUR MED EXP (Arty one person) ' S 5 0 0 0 -- A X Sexual /MOlestatio PERSONAL & ADV INJURY S 1 , 00_0 000 _ GENERAL AGGREGATE_ S Q 0 0 0 , 0 0 0 GENE AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2 , 00 0 1000 POLICY PRO• JLOC ECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO (Ea seddent) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY u r NON-OWNED AUTOS (Perecdoent) $ - - PROPERTY DAMAGE S -.r • -- (Por acddanq GARAGE LIABIUTY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG S i EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE 5 S DEDUCTIBLE S RETENTION S S WORKERS COMPENSATION AND TORY LIMITS X1 ER EMPLOYERS' LIABILITY B IANYPROPRIETOWPARTNERIEXEcurIVE 21WBDU9567 12 / 01 / 03 12 / 01/ 04 E.L. EACH ACCIDENT $ 500 , 000 —` OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE S 500 O O 0 If ycs, dcscdbe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500 000 OTHER ' ]AProfassional Liab PHPK071434 03 / 26 / 04 03 / 26 / 05 Occurrenc $ 1 , 000 , 000 Aggregate $ 2000 000 aESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Company A : Employee Dishonesty , Policy ##PHPK071434 , 03 / 26 / 04 - 03 / 26 / 05 , $ 100 , 000 Blanket Form A . Certificate holder is an additional inured for general liability with respects to Safe Families & Valued Visits Programs . * 10 days non - payment of premium . CERTIFICATE HOLDER CANCELLATION INDIA - 2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENOEAVORTD MAIL 301P DAYS WRITTEN Indian River County NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 184 0 25th Street s a ionera 1840 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Vero Beach Fla 32960 REPRESENTATIVES. - AUTHORIZED REPRESENTATIVE JCindy McCall r ' CORD 25 (2001108) ® AC RD CORPORATION 1988