Laserfiche WebLink
M CORD I DATE (MMIDDlYY) <br /> STM. CERTIFICATE OF LIABILITY INSURANCE ! OCT 1705 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> PAT O'CONNELL IN 'URANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 1148 VISTA ROYALE :,QUARE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> VERO BEACH FL 329x:2 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> PHONE : 772567-7774 <br /> FAX: 772=5670166 INSURERS AFFORDING COVERAGE MAIC # <br /> Agency LiC#: A194679 <br /> INSURED INSURER A: Westport Insurance <br /> GIFFORD YOUTH ACTIVI-; Y CENTER , INC . f INSURER B : <br /> P O BOX 339 INSURER C: <br /> VERO BEACH FL 32961 � — — <br /> INSURER D: <br /> INSURER E : — <br /> COVERAGES <br /> THE POLICIES CF INSURANCE LISTED Bi '-0W HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br /> ANY REQUIREMENT, TERRI OR CONDITIOk OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE A.FFORDEL BY THE POLICIES DESCRIBED HEREIN IS SUBJEC' TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCfi <br /> POLICIES, AGGREGATE LIMITS SHOWN MAY iAVE BEEN REDUCED BY PAID CLAIMS. ---� <br /> TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE I POLICY EXPIRATION I LIMITS <br /> LT DATE NNA)D,Nt I DATE MIDDIYY <br /> GENERAL LIABILITY EACH OCCURRENCE <br /> r F <br /> COMMERCIAL GENERAL LIABILITY rDAM4GE TO RENTED <br /> 715E5 i a Drrduepcel $ <br /> CU41MS MADE OCCUR i IatED. EXP (Any One Pe 'oc) I—�— <br /> PERSONAL b ADV INJURY $ <br /> GENERAL .AGGREGATE — $ <br /> GEN'LAGGREGATE <br /> ELLIMIT APPLIES PER PRODUCTS-COMP/OPAGG . S <br /> POLICY ( I I --- <br /> IAUTOMOBILE LIABILITY <br /> r__11 COMBINED SINGIE LIMIT i <br /> ! ANY AUTO . iEe accident) — I $ <br /> ALL OWNED AUTOS rSODIpi� URY <br /> X SCHEDULEDAUTOS INJerson ) � $ <br /> HIRED AUTOS BODIL`! INJURY $ <br /> I NON-OWNED AUTOS i (Per ecudenl) I <br /> PROPERTY DAMAGE $ <br /> , <br /> GARAGE LIABILITY I ! AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER THAN EA ACC I $ <br /> , AUTO ONLY: AGG 5---- ---- -- --- ---- - <br /> I �. . <br /> EXCESS / UMBERELLA LIABILITY i ! EACH OCCURRENCE S <br /> L-1 OCCUR I CLAIMS MADE AGGREGATE $ <br /> I $ <br /> DEDUCTIBLE i S <br /> RETENTION S I 5 <br /> 1 WORKERS COMPENSATION AND {NL ' )(297281 JAN 4 GS JAN 4 06 I X i 'T"`O y uNlrs oTHEit I <br /> EMPLOYERS' LIABILITY - - <br /> A ANY PROPRIETORIPARTNmExECUTNE i I E.L. EACH ACCIDENT S 1000000 <br /> WICERIM@UBER EXCLUDED? E.L DISEASE-EA EMPLOYEE S 10U ,D00 <br /> 1t yes, describe under I <br /> SPECIAL PROVL410N9 bkwr E.L. DISEASE-POLICY LIMIT Is 500,000 <br /> ( OTHER: j <br /> DESCRIPTION OF OPERATIONSILOC rIONIVEHICLESJEXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER AODITIOK LINSURED; INSURER LETTER: _ CANCELLATION <br /> INDIAN RIVER COUNTY SHOULD ANY CF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> BOARD OF COUNTY COk Yli 510 1 FXPIRATIDN DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 <br /> DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> 1840 25TH STREET FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> VERO BEACH, FL 32960 INSURER, 1'1 'S AGENTS CR REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> Attention : <br /> ACORD 25 (2001108) Ceruncate # 1144 David O' Connell <br />