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' '� `- "= ` ' � � � � u11 \U1JI \ II YJUI �I iI I ..L 1IUL-1 7l. l 11G. '-'IUU LJ1J I • � ( / 1C OP ID DATE (MMIDDIYYYY) ACORU� CERTIFICATE OF LIABILITY INSURANCE EXCHA_ 1 05 / 1a / 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, Pierce FTI 34950 - 5309 's _.�ne : 772 - 467. - 6040 Fax : 772 - 460 - 2315 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A; Philadelphia Indemnity Ina Co The Exchange Club Centex - fo the Prevention of INSURER B: Hartford Ins Co of the Midwest Chld Abuse DHA Vxchange Club C . A . S . T . L . E . INSURER C : _ PO Box 12908 Ft Pierce FTI 34979 INSURER 0: INSURER E: COVERAGES THE POLICIES 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 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 ALL T14F TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INS Y POLICY NUMBER ETCYEFFECT TTCYEXPIRATId J LIMITS LTR NSR - TYPE OF INSURANCE DATE MWOD DATE MMIDOM GENERAL LIABILITY EACH OCCURRENCE $ 1F000 , 000 A X X COMMERCIAL GENERAL LIABILITY PHPK071434 03 / 26 / 04 03 / 26 / 05 PREMISES (Ea occurenco ) 51000000 CLAIMS MADE L �_J OCCUR MED EXP (Any one person) r $ 51000 A . X Sexual /Molestatio PERSONAL & ADV INJURY $ 1 , 00_0 000 GENERAL AGGREGATE_ S 2 . 0 0 0 , 0 0 0 GEN L AGGREGATE LIMIT APPLIES PER; PRODUCTS COMP/OP AGG $ 2 , O 0 0 / 0 O O POLICY 0 PRO• LOC JCC T AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S ANY AUTO (Ea Acddent) ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY x $ NON-OWNED AUTOS (For Baddent) �. PROPERTY DAMAGE 5 (PoracddcnI) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANVAUTO 0THE RTHA N [A ACC $ AUTO ONLY: AGG 6 i EX_CESSNMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR U CLAIMS MADE AGGREGATE S -+ S DEDUCTIBLE S RETENTION S - - WUSIAIIJ, $ WORKERS COMPENSATION AND TORY LIMITS X ER EMPLOYERS' LIABILITY B I ANY PROPRIETORIPARTNERIEXECUTIVE 21WBDII9 5 6 7 12 / 01 / 03 12 / 01 / 04 E.L. EACH ACCIDENT $ 5 0 0 , OFFICEWMEMBEREXCLUDED? E-L. DISEASE - EA EMPLOYEE1 S 500 000 Ifms dascrlue under SPECIAL PROVISIONS bHow E.L. DISEASE - POLICY LIMIT S 500 00 0 OTHER A Professional Liab PHPK071434 03 / 26 / 04 03 / 26 / 05 Occurrenc $ 1 , 0001000 Aggregate $ 2000000 oESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Company A : Employee Dishonesty , Policy # PHPK071434 , 03 / 26 / 04 - 03 / 26 / 05 , $ 100 , 000 Blanket Sorin A . Certificate holder is an additional inured for general liability with respects to Safe Families & Valued Visite Programs . * 10 days non - payment of premium . ; ERTIFICATE HOLDER CANCELLATION INDIA - 2 SHOULD ANYOF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVORTO MAIL 30 * DAYS WRITTEN Indian River County NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 184Commissioners025 2 5 th Street 1840 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURM ITS AGENTS OR Vero Beach FL 32960 REPRESENTATIVES. AUTHORIZED REPRESENTATNE ICindy McCall % CORD 25 (2001108 ) © AC RD CORPORATION 1988