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11 / 12 / 2003 16 : 46 FA% 772 562 3466 SID BANACK INS : 001 / 001 ACORD E (arluOorYY) ,l TMGAT . CERTIFICATE OF LIABILITY INSURANCE DATE PRODVCER $ ID 1K INSURANCE AGENCY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 204$ 14TH 4TI4 AVE. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P O BOX 130 HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR VERO BEACH FL 32961 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE : 7724624369 INSURERS AFFORDING COVERAGE NAIC # _ .. _ _ . _.. ... . — . . __ ._ .. ._ ._.. _ . ._. _ . ._. INSURED INSVRERA: HARTFORD CASUALTY INSURANCE CO_ COMMUNITY CHILD CARE RESOURCES , INC . Ciq CCCR, INC- INSURER e: MARTINS CO OF SOUTHEAST 1027120 — . . — - - ' - P. O, BOX 34 $1 ' INSURER C: —. — VERO BEACH , FL 32964 INSURER D; INSURER E : COVERAGES THE POLICIES OF INSURANCE LISTED EELOW HANE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TME POLICY PERIOD INDICATED, NOTWITHSTANDI ANY REQUIREMCNT , TERM OR CONCITION OF ANY CONTRACT OR OTHER OOCLWNT WITH RESPECT TO WHICH THIS CERTIFICATE MAY NG BE ISSUED AN MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SVBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, 1N . .. —_.. .-.. . . LT TYPE OF INSURANCE POLICY NUMBER POLICY CPPECTN[�roucY E PfRATrT LlMlrs PATO N�WODIW DATE MMIDO ceuaRAl LlAalurY X 21 SBA FP5973 DV OCT 14 03 i OCT 14 04 EACH OCCURRENCE s 1 ,000, 000 COMMERCVIL GENERAL LIABILITY I j DAMAGE TO RENTED ' s 300 000 CLABAS MADE 17 OCCUR I MED. I MED. EXP IArn• One Person; IS 101000 A - - - - PERSONAL L ADV INJURY S � I .. _. _.._ 1 .0,000 -- -� - I GENERAL ACCREGATE -�S— I GEN•L AGGREGATE LIMIT APPLIES PER: j r • ---•• _ Z_OOOr000 i ._ - I PO .ICY - -� .I I i PRODUCTS-COMPlOP AGG. IS • •- 21000,000 P I AUTOMOBILE UAdLTTV ! 21 SBA FP6973 DV OCT 14 03 OCT1404 ANY AUTO I COM21NEO SINGLE LIMIT S 000 000 I i � I (Ee eccloerN) , All, OWNED AUTOS — I— I BODILY INJURY A - I SCHEDULED AUTOS I I (Parpar:on) Is I � i HIREDAVTOS I '— '- - - • - • --- - - •- - L_"I BODILY INJURY � S X NON- OWNED AUTOS I (Per accbenl) PROPERTY DAMAGE {S GARAGE LIABILITY I ALTO ONLY • EA ACCIDENT I $ ANY AUTO _ I OTHER THAN EA ACCs _ 1 I AUYO ONLY: A3Q S EXCESS UMeEFEL44 LIABILITY EACH OCCURRENCE{ E OCCUR CLAIMS MADE ' AGGREGATE I - - --- -- - S DEDUCTIBLE •--- -- RETENTION g _ — $ I : WORKERS COMPENSATION AND 21WECDQ6422 ��CaTAru ciHER Ek PLOYER9 uABn IrY Ij OCT 14 03 OCT 14 04 �pRy UMITS x _ $ IArty PRDPRIkfcwPARTNtWfAtCMTf" I El, EACH ACCIDENT S 500,000 DFFlCEIRINGH EA EXCLUDEW _ _ Y rw, dwcMc YOM' I E L. DISEASE-EA EMPLOYEE $ $QQ ,000 SPECIAL MIONbIOM ONew E.L. DISEASE -POLICY LIMIT S $OO ,000 ' OTHER DESCRIPTION OF OPERATIONSILOCATION/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 ADDITIONAL INSURED; INSURER LETTER: _ CANCELL.,TION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL U DAYS WRITTEN NOTICE 70 THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INDIAN RIVER COUNTY FLORIDA INSIVER, rS AGENTS OR REPRESENTATIVES. 1840 25TH STREET VERO BEACH, FL 32960-3365 AUTHORIZED REPRESENrATtVE � 7 Attention : JOYCE JOHNSON - FAX #978-1798 ' f"� 7 ACORD 26 (2001108 ) Certificate # 70671 Sidney M. Eanaek , Jr.