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2005-328f
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2005-328f
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Last modified
8/10/2016 1:10:49 PM
Creation date
9/30/2015 9:12:45 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
10/04/2005
Control Number
2005-328F
Agenda Item Number
7.JJ.
Entity Name
Gifford Youth Activity Center
Subject
Summer Cultural Camp Children's Services Advisory Grant Contract
Supplemental fields
SmeadsoftID
5197
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ACORD CERTIFICATE OF LIABILITY INSURANCE DATE <br /> OCT11705 <br /> w <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 329.:2 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> PHONE : 772567.7774 <br /> FAX: 772-567.01 _ AQencLiC#: 4194679 66 INSURERS AFFORDING COVERAGE NAIC # <br /> _ —_ y <br /> INSURED i NSURER A: Westport Insurance — <br /> GIFFORD YOUTH ACTIVI-; Y CENTER , INC . ( INSURER B : <br /> P O BOX 339 1 INSURER C: <br /> VERO BEACH FL 32961 — <br /> INSURER D: <br /> INSURER E : — <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BL '.OW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD WDICATED, NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH <br /> POLICIES, AGGREGATE LIMITS SHOWN MAY iAVE BEEN REDUCED BY PAID CLAIMS. �r <br /> TYPE OF INSURANCE I POLICY NUMBER Poucr EFFECTIVE I poucY EXPIRATION OMITS <br /> ILT DATE NOMDNY I DATE M,DDlYY <br /> lT <br /> GENERAL LIABILITY I EACH OCCURRENCE _ _$ <br /> FDAM4CE TO RENTED <br /> LIABILITY - i-- <br /> r� I I <br /> ! COMMERCIAL GENERALI $ <br /> �F 1i 1,5 .e rPa nruvencel _ <br /> CLAIMS MADE '� OCCUR I f MED. EXP (Any One Penson ) IS ---- -- - — -- _- <br /> I- { -- - —a ------ - <br /> t <br /> � PERSONALB ADV INJURY $ <br /> GENERAL .AGGREGATE $ — - <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/DP AGG . $ <br /> POLICY ' 1 <br /> AUTOMOBILE LIABILITY <br /> _ COMBINED SINGLE LIMIT � <br /> ANY AUTO I (Ea awdert) <br /> ALL OWNED AUTOS rSODR�TWJURY <br /> X SCHEDULEDAUTOS erson) -- <br /> HIREDAUTOS <br /> BODILY INJURY I $ <br /> i NON-OWNED ALTOS i I (Per acudenq f <br /> -- -- — i PROPERTY DAMAGE $ <br /> i <br /> GARAGE LIABILITY ! ! AUTO ONLY • EA ACCIDENT II5 <br /> ANY AUTO I OTHER THAN -- cA ACC I s — <br /> I •�` I , <br /> AUTO ONLY: AGG S <br /> IEXCESSIUMBERELLALIABILITY i I EACH OCCURRENCE _ S <br /> FL OCCUR I CLAIMS MADE AGGREGATE $ <br /> I 1 — — -- <br /> r I DEDUCTIBLE <br /> --il, RETENI.1014 S ( ~ S <br /> WORKERS CCMPENSATION AND VLfL 'X.79T2H1 I JAN 4 015 JAN 4 06 X wC STATJ- i OTHE2 <br /> EMPLOYERS' LIABILITY I <br /> A iANY PROPRIETOR+PARTNERIEXEWTIVE I ( EL EACH ACCIDENT : $ 'I UU,QOU <br /> OFFICENMeMBEREXCLUDE07 E.L. DISEASE•EA. EMPLOYE.E S 100 ,000 <br /> It yet, della t o Under <br /> SPECIAL PROVISIONS Mlaw , E.L DISEASE-POLICY LIMIT 500,000 <br /> ( OTHER: <br /> DESCRIPTION OF OPERATIONS/ LOC TIONIVEHICLESlEXCLUSIONS ADDED ENDORSEMENT/ SPECIAL PROVISIONS <br /> T.... <br /> CERTIFICATE HOLDER ADDITIGn LINSURED; INSURER LETTER : CANCELLATION <br /> INDIAN RIVER COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> BOARD OF COUNTY COIiHi`aSIO d FJWiRAT10N DATE THEREOF, THE ISSUING COMPANY VNILL ENDEAVOR TO MAIL 10 <br /> DAYS J/RITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> 11840 25TH STREET FAILURE TO DO SO SHALL IMPOSE NO OBL'GATION OR LIABILITY OF ANY KIND UPON THE <br /> VERO BEACH, FL 32960 INSURER, I•f'S AGENTS OR REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> Attention : <br /> ACORD 25 (2001 /06) Certificate # 1144 David O' Connell <br />
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