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Lu O 10101 <br /> ACaORA CERTIFIGA I t ur L IADILI 1 T 11mour Aiv %.PGHIBIS - 2 ' 09 / 25 / 03 <br /> Pp,ODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> R , V . Johnson Agency , Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 2041 SE Ocean Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> Stuart FL 34996 <br /> Phone : 772 - 287 - 3366 Fax : 772 - 287 - 4255 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A Markel Insurance CO <br /> r • <br /> INSURER B: Dridoeri ald rawloyorm Ineura,nc <br /> Hibiscus Childrens Center Inc PDQ INSURER C: <br /> Hibiscus Childrens Foundation <br /> P O Box 305 INSURER D: <br /> Jensen Beach FL 34958 <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTIMTHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LTR INSRCI TYPE OF INSURANCE POUCY NUMBER DATEM� M/�DD DATE MMDYf LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE s 1 , 000 , 000 <br /> A X X COMMERCIAL GENERAL LIABILITY BINDER 07 / 12 / 03 07 / 12 / 04 PREMISES (E3o=rente) $ 100 000 <br /> CLAIMS MADE OCCUR MED EXP (Any one porson) 5 5 r 0 0 0 <br /> X Abuse / MOlestatio 51 , 000 , 000 / ;3 , 000 , 000 PERSONAL & ADV INJURY _911000 , 000 <br /> X Ltd Professional Si , 000 , 000 / S3 , 0oD , o0o GENERAL AGGREGATE S 3 000 , 000 <br /> GEMLAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3 , 000 , 000 <br /> POLICY PRO- <br /> JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED <br /> A X ANY AUTO BINDER 07 / 12 / 03 07 / 12 / 04 (ER "09m)SINGLE LIMIT 51 , 000 , 000 <br /> ALL OWNED AUTOS — <br /> • BODILY INJURY $ <br /> SCHEDULED AUTOS (Por person) <br /> X HIRED AUTOS <br /> BODILY INJURY $ <br /> X NON-OWNED AUTOS (Per w=-Ident) <br /> PROPERTYDAMAGE $ <br /> (Per acdoenr) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO <br /> OTHER THAN EA ACC <br /> AUTO ONLY: AGG S <br /> EXCESarUMBRELLA LIABILITY EACH OCCURRENCE $ 1 , 000r000 <br /> A X OCCUR CLAIMS MADE BINDER 07 / 12 / 03 07 / 12 / 04 AGGREGATE 31 , 000 , 000 <br /> $ <br /> DEDUCTIBLE 3 <br /> X RETENTION 510 000 $ <br /> WORKERS COMPENSATION AND TORY LIMITS ER <br /> B EMPLOYERILITY 0830 - 28580 02 / 22 / 03 02 22 <br /> ANY PROPRIETORETORIPARTNER/EXECUTfVE / / O4 E.LEACHACCIDENT • 500 , 000 <br /> OFFICER/MEMBER EXCLUDED? E, L DISEASE . EA EMPLOYE $ 500f000 <br /> SPEC9,IAL DaPscrROVISIONfbe under S below EL DISEASE - POLICY LIMIT $ 500 , 000 <br /> S <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEH'ZLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> 30 days notice of cancellation for workers compensation coverage . <br /> Certificate holder is added as additional insured ( not applicable for <br /> workers compensation ) . Attn : Joyce Johnston Carlson <br /> CERTIFICATE HOLDER CANCELLATION <br /> BOARD04 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br /> DATE THEREOF, THE 13SUING INSURER WILL ENDEAVOR TO MAIL 10 * DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 30 SHALL <br /> Board Of County Commissioners <br /> Indian River County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> 1840 25th Street REPRESENTATIVES. <br /> Vero Beach FL 32960 AUTHO D PRESENjA'f1VE <br /> ACORD 25 (2001 /08) m ACORD CORPORATION 1988 <br /> TO/ T0 - d SS2b LGE TSS ' SNI NOSNHOf Oa TOOT 200c-SE-63S <br />