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2009-065O
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2009-065O
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Last modified
3/4/2016 9:35:51 AM
Creation date
10/1/2015 3:21:28 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
03/10/2009
Control Number
2009-065O
Agenda Item Number
8.F.
Entity Name
Exchange Club Center for the Prevention of Child Abuse
Subject
Safe Families Program Grant
Children's Services Advisory Committee
Supplemental fields
SmeadsoftID
10506
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DATE (MMIDDI(YYYY) <br /> Client# : 2414 CASTLE <br /> C RDTM CERTIFICATE OF LIABILITY INSURANCE 04/23/2008 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Brooks Insurance Agency, Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER, THIS CERTIFICATE DOES NOT AMEND , EXTEND OR <br /> 1120 Madison Ave . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Toledo, OH 43604 <br /> 419 243- 1191 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURERA: Philadelphia Insurance Company <br /> Exchange Club Castle INSURER B: <br /> P . O . Box 12908 INSURER C: <br /> Fort Pierce , FL 34979 INSURER D: <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 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 /> D' POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> IN R D <br /> LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE (MI <br /> A X GENERAL LIABILITY PHPK302656 03/26/08 03/26/09 EACH OCCURRENCE $ 1 000 000 <br /> DAMAGE TO RENTED $ 100000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES (Eg n <br /> CLAIMS MADE � OCCUR MED EXP (Any one person) $5000 <br /> PERSONAL & ADV INJURY $ 1 000 000 <br /> GENERAL AGGREGATE $3 00O OOO <br /> PRODUCTS - COMP/OP AGG s3 , 000 ,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: <br /> PRO- LOC <br /> POLICY JECT El <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY $ <br /> (Per person) <br /> SCHEDULED AUTOS <br /> HIREDAUTOS BODILY INJURY $ <br /> (Per accident) <br /> NON-OWNED AUTOS <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> AUTO ONLY - EA ACCIDENT $ <br /> GARAGE LIABILITY <br /> ANY AUTO <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EACH OCCURRENCE $ <br /> EXCESS/UMBRELLA LIABILITY <br /> AGGREGATE $ <br /> OCCUR CLAIMS MADE <br /> DEDUCTIBLE <br /> RETENTION $ WC STATU- OTH- <br /> WORKERS COMPENSATION AND <br /> EMPLOYERS' LIABILITY E. L. EACH ACCIDENT $ <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E. L. DISEASE - EA EMPLOYEE $ <br /> OFFICER/MEMBER EXCLUDED? <br /> If yes, describe under E. L. DISEASE - POLICY LIMIT $ <br /> SPECIAL PROVISIONS below <br /> A OTHER PHPK302656 03/26/08 03/26/09 $ 1 , 000 ,000 per Occur. <br /> Professional Liab $ 3 , 000 , 000 Agg . <br /> Sexual Abuse PHPK302656 03/26/08 03/26/09 $ 1 , 000 ,000/$2, 000 ,000 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> Indian River County are an additional insured ATIMA per form CG2026 7/04 attached . <br /> aYM=t-of Premium <br /> CERTIFICATE HOLDERIII CANCELLATION - <br /> �iiIIIIIIIIIIIIIIIIIIIIIIIIISHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> Indian River County DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1_ DAYS WRITTEN <br /> 1800 27th Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> Vero Beach , FL 32960 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> ) Jul ' p�j /r <br /> log a <br /> )I �4zllk4va) <br /> KALIC © ACORD CORPORATION 1988 <br /> ACORD 25 (2001 /08) 1 of 2 #S33379/M33261 <br />
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