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Pi C®RD DATE (MM/DDtYY) <br /> ACORDTM. CERTIFICATE OF LIABILITY INSURANCE OCT 170S <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> 4PAT O'CONNELL IN URANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> ` 148 VISTA ROYALE :,QUARE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> VERO BEACH FL 329.,2 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> PHONE : 772567-7774 <br /> FAX: 7724674166 Agency Lic#: A194679 INSURERS AFFORDING COVERAGE MAIC # <br /> _ <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 OF INSURANCE LISTED SCOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOb'E FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITI01. OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE A.FFORDEL BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES, AGGREGATE LIMITS SHOWN MAY 1AVE BEEN REDUCED BY PAID CLAIMS. --� <br /> W • TYPE OF INSURANCE i POLICY NUMBER POLICY SFFECTWE I POLICY EXPIRAnoN LIMITS <br /> LT DATE NM/DD1YY I DATE EMID= <br /> GENERAL LIABILITY I '{—EACH OCCURRENCE - <br /> r� <br /> COMMERCIAL GENERAL LIABILITY i DAM4GETORENTED — <br /> i �ISFS (ia rxulrznoel $ <br /> �7 - <br /> j CLAIMS MADE I� OCCUR I ( LSEO. EXP (Any One Peraec ) $ <br /> I i- - -- —+--- --- - . _ . <br /> ' PERSONAL & ADV INJURY $ -- <br /> 1 GENERAL AGGREGATE $ <br /> GENTAGGREGATE LIMIT APPLIES PER i PRODUCTS-COMP/OP AGG . S <br /> l POLICY ` PROAFCT I nc iI ---- -- ' ----- <br /> AUTOMOBILE LIABILITY <br /> _ COMBINED SING( E LIMIT I <br /> ilia ecc:dent) $ <br /> ANY AUTO — <br /> F ALL OWNED AUTOS BODILY INJURY <br /> X SCHEDULED AUTOS (Per person ) -- <br /> i I <br /> HIRED AUTOS BODILY NJUP,Y $ <br /> i NON-OWNEDAUTOS i (Perocudetl) 1 <br /> -- ---- i iPROPERn DAMAGE iS <br /> GARAGE LIABILITY ! ! AUTO ONLY - EA ACCIDENT 5 <br /> - --- - -- - - - <br /> ANY I I OTHER THAN EA ACC S <br /> AUTO ONLY: AGG S <br /> � <br /> EXCESS / UMBERELLALIABILITY I - EACH OCCURRENCE Is — <br /> I—� <br /> I � OCCUR CLAIMS MADE i AGGREGATE ! $ _— _- <br /> S <br /> f� DEDUCTIBLE i <br /> RETENTION $ ( S <br /> I WORKERS COMPENSATION AND —Y WLX297281 JAN 4 05 wC STAr1 OTME� <br /> ' ! JAN 4 06 X i <br /> EMPLOYERS LIABILITY I JMITS t <br /> A � ANYPROPPJETOR+PARTNER=ECUTIVE I { ELL, EACH ACCIDENT ; S 1OO,QOU <br /> OFFICERN91AIER EXCLUDED? III E.L DISEASE,EA EMPLOYEE S __ SOU ,000 <br /> It ym desefte Under —�--- <br /> SPECIAL PROVISIONS Cebu E.L. DISEASE-POLICY LIMIT "a 500 ,000 <br /> ( OTHER: <br /> DESCRIPTION OF OPERATIONSILOC rIONIVEHICLES/EXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER ADDITION LINSURED; INSURERLETTER: _ CANCELLATION <br /> INDIAN RIVER COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> BOARD OF COUNTY COMiNiSS ) OU FXPiRATIOPI DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO NAIL ID <br /> DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> 1840 25TH STREET FAILURE T 0 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> VERO BEACH, FL 32964 INSURER, IIS AGENTS OR REPRESENTATIVES. <br /> AU"fHORIZEO REPRESENTATIVE <br /> Attention : <br /> ACORD 25 (2001108) Cerdflcats # 1144 David O' Connell <br />