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11 / 12 / 2003 16 : 46 FAX 772 562 3466 SID BANACK INS .' Z001 / 001 A CORD DATE (WAIDON" ) TM. CERTIFICATE OF LIABILITY INSURANCE NOV1203 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION SID BANACK INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 2045 14TH AVE. HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P O BOX 130 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, VERO REACH FL 32901 PHONE: 772-562.3369 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: HARTFORD CASUALTY INSURANCE CO_ COMMUNITY CHILD CARE RESOURCES , INC . C/O CCCR, INC. INSURER 8 : HART INS CO OF SOUTHEAST - - -- D 02 i 27120 P . O. BOX 3451 ' INSURER C: VERO BEACH , FL 32964 INSURFR D: r INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED EELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 Au THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, IP. TYPE OF INSURANCE POLICY NUMBER POLKY ePPeCTIVe FOUCY EAPIRATION lT TC N,WODAY) DATE (MKOOrrnLIMITS G12NERAL LIABILITY 21 SBA FP5973 OV OCT 14 03 OCT 14 04 / EACH OCCURRENCE _ , s _ 11000, 000_ X COMMERCIAL GENERAL LIABILITY I I FRE GANIAOE $ RENTED I -S _, IL (E � 300 , 000 CLAIMS MADE `7 OCCUR MED. EXP (Any One Pelson; is 1 D9000 A PERSONAL & ADV INJURY is 180000000 GENERAL I-� _ 200 00100() I GEN'L AGGREGATE LIMIT APPLIES PER: "--" - -- PRODUCTS-COMP/OP AGG. S _2,0001000 PO ,ICY I AUTOMOBILE LJABILRY 21 SBA FP6973 DV OCT 14 03 I OCT 14 04 COMBINED SINGLE LIMIT ANY AUTO I tee ecdaerv) Is — — 1 ,000 , 000 All OWNEO AUTOS I BODILY INJURY A _ SCHEDULED AUTOS I I (Por pa.vni Is X i HIRED AUTOS I X NON- OWNED AUTOS I BODILY INIURY IS I IlPoracckenli - _ - - - -- PROPERTY DAMAGE - � S I GARAGE LIABILITY i I ALTO ONLY • EA ACCIDENT IS ANYAUTO t OTHER THAN EA ACC S AUYO CNIY: AGC ' S I EXCESS I 'JuIeERF.LLA LIABILITY I EACH OCCURRENCES S OCCUR CLAIMS MADE I AGGREGATE IS - --- - - - _ — - � DEDUCTIBLE RET'ENT10N $ WORKERS COMPENSATION ANOwe aYAru 21 WEC D06422 ! OCT 14 03 OCT 14 04YuMiTa � X CTNER I EMPLOYER!' LIABILITY B AHY PRopaET0"ARTWMeXtCVTIYE I E . L. EACH ACCIDENT t 5000000 OFFICERAW01UR EXCLUDmt M JM, dmwwwUnM1 - E L. DISEASE -EA EMPLOYEE Z erEaAL MovleroNe e.h« L E .L. DISEASE-POUCY LIMIT Ii 500p000 , OTHER I DESCRIPTION OF OPERATIONS/LOCATION/VEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED UNDER THE GENERAL LIABIUTY POLICY SUBJECT TO POLICY PROVISIONS . 10 DAY NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM CERTIFICATE HOLDER I ADDITIONAL INSURED; INSURER LEYTER: _ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED To THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INDIAN RIVER COUNTY FLORIDA INSL'RPR, rmS AGENTS OR REPRESENTATIVES. 1840 25TH STREET AUTHORIZED REPRESENTATIVE VERO BEACH, FL 32960-3365 7 Attention : JOYCE JOHNSON - FAX #978.1798 ��f; 4X4 A ACORD 26 (2001 /08 ) Certificate # 70671 Sidney M . Banack, Jr.