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NOV , 4 . 2005- 2 ; 16P - 0- 2344- P . 2 / 2 <br /> CERTIFICATE OF LIABILITY INSURANCE7 BATE ( " <br /> MDNTM <br /> 11/02/2005 <br /> PRODUClR (504) 455 -4545 FAX (504) 88$ - 6645 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Ellsworth Corporation ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> P . 0, Box 84860 HOLDER• THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Baton Rouge , LA 70884 ALTER THE GE APORIDED BY THE LIC- BELOW. <br /> 22S- 292 - 2430 INSURERS AFFORDING COVERAGE NAIC 9 <br /> wsu m Omni Pinnacle , LLC INSURERA: Scottsdale Insurance Co . 41297 <br /> 130 W . Howze Beach Rd . INsuRERe: Clarendon America Ins . Co . 43095 <br /> Sl i dei i , LA 70458 RE V1 INSURER c: Landmark American Ins . Co . <br /> SED INS~ O: American Horne Assurance Co . <br /> INSURER E: <br /> THE POLICIES OF INSURANCE LiSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWfTHSTANDINI <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 13 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> A+m TYPE OF INSURANCE POLICY NUMMPOLICY POucr EfIPIlAT10N u b <br /> GENERAL LIASA Y CLS1130371 05/07/2005 05/07/2006 EAcHOCCURRENCE s <br /> 1 000 No <br /> 10001 <br /> X COMMERCIAL GENERAL LIABILITY DAMAO TO RENTED i SO <br /> CLAIMS MADE � OCCUR MED EXP (Any on Pweon) S 1 <br /> A 40001 <br /> PERSONAL & ADV INJURY 3 1 000 <br /> GENERAL AGGREGATE 3 2 000 <br /> G@TL AGGREGATE LIMITAPPLIES PER; PRODUCTS • COMP/OP AGO S Z10001 <br /> POLICY JECOoT ri LOC <br /> AUTOMOBILE UABtNTY DSA014614 05/07/2005 OS/07/2006 O B SINGLE E LIMIT <br /> ANYI 1000 , 0 <br /> ALL OWNED AUTOS BODILY INJURY <br /> X SCHEDULED AUTOS (Per person) S <br /> B <br /> X HIRED AUTOS <br /> BODILY INJURY S <br /> X NON.OWNEDAUTOS (per ae dad) <br /> PROPERTY DAMAGE <br /> (Peraocipenq <br /> GAVE LMMBLnr AUTO ONLY • EA ACCIDENT S <br /> ANY AUTO EA ACC i <br /> OTHER THAN <br /> AUTO ONLY. AGG S <br /> EXCIMSIUMBRELLALIAMTV LHA029980 OS/07/2005 OS/07/2006 EACH OCCURRENCE a 5 000 , 00( <br /> X OCCUR CLAIMS MADE AGGREGATE i <br /> C i S 000 00 <br /> DEDUCTIBLE S <br /> X RETENTION i 101000S <br /> WORNERSCOMPENSATION AND WC1943935 09/21/2005 09/21/2006 X X!TATu 0TM- <br /> VMPLDTFA4' LJABB.ITr ER <br /> D ANY PROPRIETOIVPARTNEWExECUTIVE 61 EACH ACCIDENT i 1 OOO <br /> OFFICERIIIEMBER EXCLUDED? EL DISEASE • EA EMPLOYE 0 0 <br /> SPECIAL PR S De1PI <br /> s 100 <br /> M L !S a urMer EL DISEASE • POLICY LIMIT S 1 000 <br /> OTHER <br /> DESCWTWN OF OP TIONS I LOCATIONS I V8EC " r EXCpUMM8 ADDED BT ENDOR9alEHT I BCIAL PROVISIONS <br /> t is agreedthat the certificate holder is named as 1WJ oval Insured on the General <br /> iability policy , as required by written contract . <br /> CPA TE HOLUER <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLIOS 8E CANCELLED BEFORE TME <br /> Indian Rivers County EXPBM►TI N OATS THEREOF, THE ISSIANO INSURER WILL ENDEAVOR TO MAB. <br /> Purchasing Division 30 GAYS WRITnm NOTTCE TO THE CERTaaCATE NOLOER NAMED TO THE LEA, <br /> 1$ 40 25th Street OUT FAN_uRETOMAL SUCH NOTICE SMALL IMPOSE NOOKMATWNORuABILITY <br /> Suite N11$ OF ANY XBID UPON THE VMRER, iTS AGENTS OR REPRESENTAWK& <br /> Vero Beach , FL 32960 AMOR¢EDREIRILESENTATIK <br /> Nally Mehrtens L <br /> ACORD 28 (2001108) OACORD CORPORATION 1888 <br />