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2009-065K
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Last modified
3/4/2016 9:26:44 AM
Creation date
10/1/2015 3:20:58 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
03/10/2009
Control Number
2009-065K
Agenda Item Number
8.F.
Entity Name
Boys & Girls Club of Indian River County
Subject
Vero Beach Teen Center/Youth Volunteer Corps. Grant
Children's Services Advisory Committee
Supplemental fields
SmeadsoftID
10502
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ACORDCERTIFICATE OF LIABILITY INSURANCE <br /> *^' DATE (MM/DDIYYYY) <br /> 9 / 10 / 2008 <br /> PRODUCER <br /> ( 800 ) 794 - 0268 FAX : ( 772 ) 231 - 4413 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Brown & Brown , formerly Felten / HBA Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND , EXTEND OR <br /> 2911 Cardinal Drive ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> PO Box 643488 <br /> Vero Beach FL 32964 - 3488 INSURERS AFFORDING COVERAGE <br /> INSURED NAIL # <br /> INSURER A: Philadelphia Insurance Co <br /> Boys & Girls Club of Indian River County , Inc . INSURER B: Florida Retail Federation <br /> P . O . Box 3068 <br /> INSURER C . <br /> INSURER D <br /> Vero Beach FL 32964 - 3068 INSURER E : <br /> COVER <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING <br /> ANY <br /> REQUIREMENT , TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY <br /> PERTAIN <br /> THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND <br /> CONDITIONS OF SUCH POLICIES <br /> A GRE ATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM . <br /> INSR ADD' L <br /> TYPE OF INSURANCE POLICY NUMBER ATEYMMIDDnYE POLICY <br /> MDEXPIRATION LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE _ $ 1 , 000 , 000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> A PREMISES Ea occurrence $ 100 , 000 <br /> CLAIMS MADE X OCCUR PHPK343055 9 / 13 / 2008 9 / 13 / 2009 MED EXP (Any one person $ 51000 <br /> PERSONAL & ADV INJURY $ 11000 , 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PERS GENERAL AGGREGATE $ 3 , 000 , 000 <br /> PRO- PRODUCTS - COMP/OP AGO $ <br /> POLICY F7 JECT LOC - -- <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) $ 110001000 <br /> A I ALL OWNED AUTOS PHPK343055 9 / 13 / 2008 9 / 13 / 2009 <br /> BODILY INJURY <br /> X SCHEDULED AUTOS (Per person) $ <br /> X HIRED AUTOS - <br /> BODILY INJURY $ <br /> X NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> ( Per accident) <br /> GARAGE LIABILITY <br /> AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO -------- <br /> OTHER THAN EA ACC $ <br /> EXCESS/UMBRELLA LIABILITY AUTO ONLY AGO $ <br /> EACH 0 URREN E $ <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE — <br /> RETENTION <br /> $ WORKERS COMPENSATION AND WC STATU- OTH- <br /> EMPLOYERS' LIABILITY TRV LIMIT ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E . EACH ACCIDENT $ 500 , 000 <br /> OFFICER/MEMBER EXCLUDED? 520 - 25864 9 / 13 / 2008 9 / 13 / 2009 <br /> If yes , describe under E . L. DISEASE - EA EMPLOYEE $ 500 , 000 <br /> SPECIAL PROVISIONS below <br /> OTHER <br /> E. L . DISEASE - POLICY LIMIT $ 500 , 000 <br /> DESCRIPTION OF OPERA TIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br /> Certificate holder is named additional insured <br /> CERTIFICATE HOLDER CANCELLATION <br /> [FAILURE <br /> HOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> Indian River County Board PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> Of County Commissioners 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> 1840 25th St <br /> Vero Beach , FL 32960 TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> SURER, ITS AGENTS OR REPRESENTATIVES . <br /> AUTHORIZED REPRESENTATIVE <br /> Joseph R . Chiarella <br /> ACORD 25 ( 2001 /08) © <br /> 1 u cn � a ,,, , ,,fl, no ., ACORD CORPORATION 1988 <br /> Penn t of <br />
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