Laserfiche WebLink
11 / 04 ! 2005 09 : 24 FAX 772 562 3466 SID BANACK INS . za001 <br /> . 5/Irt N <br /> A CERTIFICATE OF LIABILITY INSURANCE DATE (MNVDDNYYM <br /> TM. MOV 4 05 <br /> HILOPRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> 2045 ROGAL 6 HOODS OF FLA INC /SID BANACK INS. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATg <br /> 2043 i4TF1 AVE. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P O BOX 130 AlvT9R THE C04MAGIE AFFORDED BY THE P I I g 0 , <br /> VERO BEACH FL 32961 <br /> INSURERS AFFORDING COVERAGE NAIC Al <br /> INSURED INSURER A: GRANRE STATE IN65e-6— <br /> OIFF487S 43RD AVE Progressive D YOUTH ACTIVITY CENTER <br /> 4875 I INSURER 8: Pive American Insurance Co. 24252 <br /> 43 _ . <br /> VERO BEACH FL =6T INSURER Cc - - <br /> INSURER D: <br /> INSURER E - <br /> COVERAGES <br /> THE POUCIES Or INSURANCE LISTED BELOW NAVE BEEN 103UEO TO THE INSURED NAMED DOVE FOR THE POLICY PER*O INOK7ATED. NorwTHSTANDING <br /> ANY REOUIREI ENT, TERM OR CONDITION OF ANY CONTRACT OR OTTER DOCUMFNT W111H RESPECT TO WHICH THIS CERTIFICATE MAY Be ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLK065 DESCR18ftO HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POUCIE& AGGREGATE LIMITS SHOWN MAY HAV% BEEN REDUCED BY MID CLAW, <br /> It,T R A TYPE OF INSURANCE POLICY NUMBER POLICY EFFiCT11A POUCYW"VM A; M <br /> LTR 1 GATE o GAh UMITS <br /> GENERAL LIABILITT O2d.X-04893300/000 MAY 15 05 MAY ig 06 EACH OCCunRENCE S 1 , 0 , 000 <br /> X � COMMERCIAL GENERAL LIAWLIT� OAMAW To IIENrE3 <br /> CLAMS MADEI X OCCUR I opgoo <br /> MED. EXP (Any Oft vasoro S 105,0 <br /> A I I PERSONAL l ADV INJURY 3 , . ... 11000,000 <br /> _ I iOENERALAGGRECATE j3 3 000 QQQ <br /> IGEN'LAGGREGATE LIMIT APPLIES PER,I I i r— <br /> PRODUCTSCOMP;OP AGG. 13 100000000 <br /> 117 POLICY F7 PAG*CT LOC - "'-- -- <br /> AUTOMOBILE LIABILITY 026263054 APR 23 05 <br /> X ANY AUTO APR Z3 06 COMBINED SINGLE LIMIT <br /> (Ea sm=id my � s 1 , 000,000 <br /> All OWNED AUTOS BODILY INJURY —� <br /> B <br /> I <br /> SCHEDULED AUTOS I (Per Peron) S <br /> X {I HIRED AUTOS <br /> BODILY INJIX I NOW"CDAUf03 I (PerswunlRY S <br /> — 1 <br /> PROPERTY DAMAGE 13 <br /> "Mee LLABILITV (Pr y) <br /> AUTO ONLY - EA ACCIDENT 113 <br /> ANY AUTO I OTHER THAN EA ACC — <br /> AUTO ONLY: 3 <br /> "CESS I UMBRELLA LIABILITY JGACI OCCURRENCE S <br /> J OCCUR 17 CLAIMS MADE AGGREGATE _ — <br /> DEDUCYIELE - 3 - <br /> RETENTION 3 I - • ••- 3 <br /> ' S <br /> WOMERS COMPENSATION AND YYCBTATV- <br /> EMPLoYERsl LIAMLITY on4ut <br /> ANY PROMIETOWARTIEElMftTr4 I EL, @ACMACCIDENT $ <br /> amemmumol 0=039" <br /> eym Q,K, E.L. DISFASEFAEMPLOYEF S <br /> MECAAI Fmom"m E.L. DISEASE-POLICY LIMIT S <br /> OTHER: <br /> DESCRIPTION OF OPERATIONS&& CATIONSNE IICLESJEXCLUSIONS ADDED DY ENDORSEMENT/ SPECIAL PROVISIONS <br /> S1 ,000 DEDUCTIBLE BODILY INJURY AND PROPERTY DAMAGE COMBINED PER OCCURRENCE <br /> INDIAN RIVER COUNTY IS NAMED AS AN ADDITIONAL INSURED WITH REGARDS TO THE GENERAL LIABILITY AND AUTO POLICIES WITH <br /> RESPECTS TO THE OPERATIONS OF THE NAMED INSURED, <br /> .CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF TNF ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAI_ to <br /> DAYS YArrrEN NOTICE TO THE CERTIFICATE MOLDER MWEO TO THE LEFT, BUT <br /> FAILURE TO DO SO SHALL IMF%E NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> INDIAN RIVER COUNTY INSURER ITS AGENTS OR REPRESENTATIVES. <br /> 1810 25TH STREET <br /> VERO BEACH, FL, $2960 AUTHORIZED REPRESENTATIVE <br /> Attention: Idney M aal�� 00p*4 <br /> ACORD 25 (2001108) Certificate # 90774 ® ACORD CORPORATION 1980 <br />