HomeMy WebLinkAbout2003-253M. Indian River County Grant Contract
This Grant Contract ("Contract") entered into effective this 1st day of October 2003 by and between
Indian River County, a political subdivision of the State of Florida , 1840 25th Street, Vero Beach FL ,
32960 ("County") and Boys & Girls Club of IRC , Inc . (" Recipient") ;
of: (Address )
Center for Emotional & Behavioral Health
1190 37" Street
Vero Beach , Florida 32960
Camp Manatee Program
Background Recitals
A. The County has determined that it is in the public interest to promote healthy children in a
healthy community.
B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance" ) and established the
Children 's Services Advisory Committee to promote healthy children in a healthy community
and to provide a unified system of planning and delivery within which children 's needs can be
identified , targeted , evaluated and addressed .
C . The Children 's Services Advisory Committee has issued a request for proposals from
individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling
its purpose .
D . The proposals submitted to the Children 's Services Advisory Committee and the
recommendation of the Children 's Services Advisory Committee have been reviewed by the
County.
E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has
applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter
defined ) on the terms and conditions set forth herein .
F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (as
such term is hereinafter defined ) on the terms and conditions set forth herein .
NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and
other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged ,
the parties agree as follows :
1 . Background Recitals The background recitals are true and correct and form a material
part of this Contract.
2 . Purpose of Grant The Grant shall be used only for the purposes set forth in the
complete proposal submitted by the Recipient attached hereto as Exhibit "A" and
incorporated herein by this reference (such purposes hereinafter referenced as "Grant
Purposes") .
3 . Term The Recipient acknowledges and agrees that the Grant is limited to the fiscal
year 2003/2004 ("Grant Period") . The Grant Period commences on October 1 , 2003
and ends on September 30 , 2004 .
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4 . Grant Funds and Payment The approved Grant for the Grant Period is Twenty
Thousand Dollars ($20 , 000 . 00) . The County agrees to reimburse the Recipient from
such Grant funds for actual documented costs incurred for Grant Purposes provided in
accordance with this Contract. Reimbursement requests may be made no more
frequently than monthly. Each reimbursement request shall contain the information , at
a minimum , that is set forth in Exhibit "B" attached hereto and incorporated herein by
this reference . All reimbursement requests are subject to audit by the County . In
addition , the County may require additional documentation of expenditures , as it
deems appropriate .
5 . Additional Obligations of Recipient
5 . 1 Records . The Recipient shall maintain adequate internal controls in order to
safeguard the Grant . In addition , the Recipient shall maintain adequate records fully
to document the use of the Grant funds for at least three (3 ) years after the expiration
of the Grant Period . The County shall have access to all books , records , and
documents as required in this Section for the purpose of inspection or audit during
normal business hours at the County's expense , upon five (5 ) days prior written
notice .
5 . 2 Compliance with Laws The Recipient shall comply at all times with all applicable
federal , state , and local laws , rules , and regulations .
5 . 3 Quarterly Performance Reports . The Recipient shall submit Quarterly Performance
Reports to the Human Services Department of the County within fifteen ( 15 ) business
days following : December 31 , March 31 , June 30 , and September 30 .
5 .4 Audit Requirements If Recipient receives $25 , 000 or more in the aggregate from
all Indian River County government funding sources , the Recipient is required to have
an audit completed by an independent certified public accountant at the end of the
Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the
Recipient shall submit the audit to the Indian River County Office of Management and
Budget . The fiscal year will be as reported on the application for funding , and the
Recipient agrees to notify the County prior to any change in the fiscal period of
Recipient . The Recipient acknowledges that the County may deny funding to any
Recipient if an audit required by this Contract for a prior fiscal year is past due and has
not been submitted by May 1 .
5 .4 . 1 The Recipient further acknowledges that , promptly upon receipt of a
qualified opinion from its independent auditor, such qualified opinion shall
immediately be provided to the Indian River County Office of Management and
Budget . The qualified opinion shall thereupon be reported to the Board of
Commissioners and funding under this Contract will cease immediately. The
foregoing termination right is in addition to any other right of the County to
terminate this Contract.
5 .4 . 2 The Indian River County Office of Management and Budget reserves
the right at any time to send a letter to the Recipient requesting clarification if
there are any questions regarding a part of the financial statements , audit
comments , or notes .
5 . 5 Insurance Requirements Recipient shall , no later than September 23 , 2003 ,
provide to the Indian River County Risk Management Division a certificate or
certificates issued by an insurer or insurers authorized to conduct business in Florida
2 -
that is rated not less than category A- : VII by A. M . Best, subject to approval by Indian
River County's risk manager, of the following types and amounts of insurance :
(i ) Commercial General Liability Insurance in an amount not less than
$ 1 , 000 , 000 combined single limit for bodily injury and property damage ,
including coverage for premises/operations , products/completed operations ,
contractual liability, and independent contractors ;
( ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000
per occurrence combined single limit for bodily injury and property damage ,
including coverage for owned autos and other vehicles , hired autos and other
vehicles , non -owned autos and other vehicles ; and
(iii ) Workers ' Compensation and Employer's Liability (current Florida statutory
limit)
5 . 6 Insurance Administration . The insurance certificates , evidencing all required
insurance coverages shall be fully acceptable to County in both form and content,
and shall provide and specify that the related insurance coverage shall not be
cancelled without at least thirty (30 ) calendar days prior written notice having been
given to the County. In addition , the County may request such other proofs and
assurances as it may reasonably require that the insurance is and at all times
remains in full force and effect . Recipient agrees that it is the Recipient's sole
responsibility to coordinate activities among itself, the County, and the Recipient's
insurer(s ) so that the insurance certificates are acceptable to and accepted by
County within the time limits set forth in this Contract . The County shall be listed as
an additional insured on all insurance coverage required by this Contract , except
Workers ' Compensation insurance . The Recipient shall , upon ten ( 10 ) days' prior
written request from the County, deliver copies to the County, or make copies
available for the County's inspection at Recipient's place of business , of any and all
insurance policies that are required in this Contract . If the Recipient fails to deliver or
make copies of the policies available to the County; fails to obtain replacement
insurance or have previous insurance policies reinstated or renewed upon
termination or cancellation of existing required coverages ; or fails in any other regard
to obtain coverages sufficient to meet the terms and conditions of this Contract , then
the County may, at its sole option , terminate this Contract.
5 . 7 Indemnification . The Recipient shall indemnify and save harmless the County, its
agents , officials , and employees from and against any and all claims , liabilities ,
losses , damage , or causes of action which may arise from any misconduct, negligent
act , or omissions of the Recipient, its agents , officers , or employees in connection
with the performance of this Contract .
5 . 8 Public Records . The Recipient agrees to comply with the provisions of Chapter
119 , Florida Statutes (Public Records Law) in connection with this Contract.
6 , Termination . This Contract may be terminated by either party, without cause , upon
thirty (30 ) days prior written notice to the other party. In addition , the County may
terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the
Recipient if the County determines that such termination is in the public interest.
7 . Availability of Funds The obligations of the County under this Contract are subject
to the availability of funds lawfully appropriated for its purpose by the Board of
County Commissioners of Indian River County.
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8 . Standard Terms . This Contract is subject to the standard terms attached hereto as
Exhibit C and incorporated herein in its entirety by this reference .
IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date
first above written .
INDIAN RIVER COUNTY BOARD OF COUNTY
COMMISSIOARS
By: "/
Kenne h R . acht, Chairman
Attest : J . K . Barton , Clerk
By.
Deputy Clerk
Approved :
mes C andler, County Admi ' trat
App r v as rm nd legal sufficie
I , ssistant ty Attor
RECIPIENT:
Center for Emotional & Behavioral Health
119037 th Street
Vero Beach , Florida 32960
By: Wr a?xe�
Nam-
1. ✓-e ()/
Title
4 -
EXHIBIT A
[Copy of complete proposal/application]
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EXHIBIT B
(From policy adopted by Indian River County Board Of County Commissioners on February 19 ,
2002)
" D . Nonprofit Agency Responsibilities After Award of Funding
Indian River County provides funding to all nonprofit agencies on a reimbursement basis
only .
All reimbursable expenses must be documented by an invoice and/or a copy of the canceled
check . Any expense not documented properly to the satisfaction of the Office of Management &
Budget and/or the County Administrator may not be reimbursed .
If an agency repeatedly fails to provide adequate documentation , this may be reported to the
Board of Commissioners . In the event an agency provides inadequate documentation on a
consistent basis , funding may be discontinued immediately. Additionally, this may adversely
affect future funding requests .
Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For
example , no expenditures prior to October 1St may be reimbursed with funds from the following
year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not
carried over to the next year unless expressly authorized by the Board of Commissioners .
All requests for reimbursement at fiscal year end (September 30th) must be submitted on a timely
basis . Each year, the Office of Management & Budget will send a letter to all nonprofit agencies
advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early
to mid October, since the Finance Department does not process checks for the prior fiscal year
beyond that point .
Each reimbursement request must include a summary of expenses by type . These summaries
should be broken down into salaries , benefits , supplies , contractual services , etc. If Indian River
County is reimbursing an agency for only a portion of an expense (e . g . salary of an employee) , then
the method for this portion should be disclosed on the summary. The Office of Management &
Budget has summary forms available .
Indian River County will not reimburse certain types of expenditures . These expenditure types are
listed below .
a . Travel expenses for travel outside the County including but not limited to ; mileage reimbursement,
hotel rooms , meals , meal allowances , per Diem , and tolls . Mileage reimbursement for local travel
(within Indian River County) is allowable .
b . Sick or Vacation payments for employees . Since agencies may have various sick and vacation
pay policies , these must be provided from other sources .
c . Any expenses not associated with the provision of the program for which the County has awarded
funding .
d . Any expense not outlined in the agency's funding application .
The County reserves the right to decline reimbursement for any expense as deemed necessary."
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EXHIBIT C
STANDARD TERMS FOR GRANT CONTRACT
1 . Notices : Any notice , request, demand , consent , approval or other
communication required or permitted by this Contract shall be given or made
in writing , by any of the following methods : facsimile transmission ; hand
delivery to the other party; delivery by commercial overnight courier service ;
or mailed by registered or certified mail ( postage prepaid ) , return receipt
requested at the addresses of the parties shown below:
County : Joyce Johnston - Carlson , Director
Indian River County Human Services
184025 th Street
Vero Beach , Florida 32960-3365
Recipient :
Center for Emotional & Behavioral Health
119037 th Street
Vero Beach , Florida 32960
Attention : Dr. Dean , Executive Director
2 . Venue ; Choice of Law: The validity, interpretation , construction , and effect
of this Contract shall be in accordance with and governed by the laws of the
State of Florida , only. The location for settlement of any and all claims ,
controversies , or disputes , arising out of or relating to any part of this
Contract , or any breach hereof, as well as any litigation between the
parties , shall be Indian River County , Florida for claims brought in state
court , and the Southern District of Florida for those claims justifiable in
federal court.
3 . Entirety of Agreement: This Contract incorporates and includes all prior and
contemporaneous negotiations , correspondence , conversations ,
agreements , and understandings applicable to the matters contained herein
and the parties agree that there are no commitments , agreements , or
understandings concerning the subject matter of this Contract that are not
contained herein . Accordingly, it is agreed that no deviation from the terms
hereof shall be predicated upon any prior representations or agreements ,
whether oral or written . It is further agreed that no modification ,
amendment or alteration in the terms and conditions contained herein shall
be effective unless contained in a written document signed by both parties .
4 . Severability: In the event any provision of this Contract is determined to be
unenforceable or invalid , such unenforceability or invalidity shall not affect
the remaining provisions of this Contract , and every other term and
provision of this Contract shall be deemed valid and enforceable to the
extent permitted by law. To that extent, this Contract is deemed severable .
5 . Captions and Interpretations : Captions in this Contract are included for
convenience only and are not to be considered in any construction or
interpretation of this Contract or any of its provisions . Unless the context
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indicates otherwise , words importing the singular number include the plural
number, and vice versa . Words of any gender include the correlative words
of the other genders , unless the sense indicates otherwise .
6 . Independent Contractor. The Recipient is and shall be an independent
contractor for all purposes under this Contract . The Recipient is not an
agent or employee of the County , and any and all persons engaged in any
of the services or activities funded in whole or in part performed pursuant to
this Contract shall at all times and in all places be subject to the Recipient 's
sole direction , supervision , and control .
7 . Assignment. This Contract may not be assigned by the Recipient without
the prior written consent of the County.
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10/ 10/2003 15 : 16 HCIR 4 1 ??25634564 N0 . 143 D02
A008D INSURANCE BINDER oP , D ,� DATE
THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM.
PRODUCER COMPANY plNpl R >r
(A/CrNo �)rt): 800 - 729 - 4149 90411
Fireman ' s Fond Ins . Cos .
FFFeCTIVI!DATE 11ME DATE McNeary Healthcare FY, TIME
6525 Morrison Blvd . , Suite 200 AM '- � � 12:01 AM
Charlotte NC 28211 10 / 12 / 03 PM 12 / 11 /H03 r NOON
Florida Hospital_ Auzooiation _ TH16OINOERISISSUED TOEXTEND COVERAGE INTNEABOVE NAMED COMPANY
CODE; SUB CODE:
PER EXPIRING POLICYC MZG80819831
CUETQ ER ID: INDIA- 1 I DESCRIPTION OF OPERATIONSNEHICLEWPROPERTY (Indudlnp Location)
INSURED
Indian River Manorial Hospital
Greg Morgan
1000 34th Street
Vero Beach FL 32960
COVERAGES LIMITS
TYPE OF INSURANCE COVERAGE/FORMS DEDUCTIBLE COINS X AMOUNT
PROPERTY CAUSES OF LOSE
BASIC _ BROAD ] SPEC
I
I
GENERAL LIABILITY I EACH OCCURRENCE f
COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any ono firs) S��
CLAIMS MADC I OCCUR MED EXP (Any cn. palsan) $
PERSONAL d AOV INJURY S
GENERAL AGGREGATE $
RETRO DATE FOR CLAIMS MADE: PRODUCTS a COMP/OP AGG $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMITS 2 , 000 000
.X ANY AUTO BODILY INJURY (Por person) f `
ALL OWNED AUTOS BODILY INJURY (Pm acr:dam) f
SCHEDULED AUTOS PROPERTY DAMAGE
_ HIRED AUTOS MEDICAL PAYMENTS 155 , 000
NON-OWNED AUTOS PERSONAL fNJURY PROT f
-DUMP P OT
L UNINSURED M46TORIST S1 , 0 0 0 , 0 0 0
f f ..
AUTO PHYSICAL DAMAGE DEDUCTIBLE X j ALL VEHICLES SCHEDULED VEHICLES i X ACTUAL CASH VALUE
XCOLLISION- 500 STATED AMOUNT S
X I OTI(ERTHAN COL' 250 _ OTHER
GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT S
ANY AUTO OTHER THAN AUTO ONLY
EACH ACCIDENT
- I AGGREGATE4114
ExCESS LIABILITY
EACH OCCURRENCE
UMBRELLA FORM AGGREGATE S r•
OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: $ELF•INSURED RETENTION S
WC STATUTORY LIMITS
WORKER'S COMPENSATION E.L. EACH ACCIDENT
AND - - -
EMPLOYER'5 LIABILIYY E.L. DISEASE - EA EMPLOYEE S
E.L, DISEASE • POLICY LIMIT f
SPECIAL BHYSICAT. DAMAGE ( CONIT ) : Ambulanoeya G Heavy Units : $ 500 DOd . Comp 6 $ 1000 FEES f
CONDITIONS/ ped Collision Ambulance Equipment ; $ 102 , 470 scheduled Equipment / 41 , 000
COVERAGES Dad except $ 50000 as respects wind/hail and flood / " Broad Form " TAXES S
ESTIMATED TOTAL PREMIUM S
NAME & ADDRESS
MORTGAGEE ADDITIONAL INSURED
LOSS PAYEE --
LOAN 0
AUT R{ D EPREZTAT
Fl ida HospitWAociation
ACORD 75-S ( 1 /98 ) NOTE : IMPORTANT STATE INFORMA ION ON REVERSE SIDE OACORO CORPORATION 1993
Internal Revenue Service
District Director Department of the Treasury
Doe: OR 2 6 1985
Employer Identification Number:
59- 2496294
Accounting Period Ending;
September 30
Form 990 Required: ® YesNo
Indian River Memorial Hospital , EJ Inc .
1000 36th Street Person to Contact
Vero Beach , FL 32960 Brenda Wilcox/cdt
Contact Telephone Number.
(404) 221 - 4516
file Folder Number ;
580062333
Dear Applicant ;
Based on information supplied'
in Your a and assuming your operations will be as stated
pplication for reco itiea „
from Federal income tax under�sectionfle ecption , we have determined
( ) ( 3 ) -of the Internal Revenueuare Code . exempt
We have further determined that
meaning of section 509 ( a ) of the Code j'obecauseu are ot a private foundation within the
section 170 (b) ( 1 ) (A) (iii) & 509 (a) ( u , You are an organization described in
If your sources of support , or
change , please let us Your purposes , character or method of operation
exempt status and foundationowe cn status, Also the
effect of the change on your
Your name or address . . You should inform us of all changes in �
As of January 1 , 1884
You are liable for taxes under the Federal Insurance
Contributions Act ( social security taxes
each of your employees during calendar on remuneration of $ 100 or more
to year . You are not liable for to You pay to
imposed under the Federal Unemployment Yment Tax Act ( FUTA ) ,
Since you are not a
private foundation , you are not subject to the excise taxes
under Chapter 42 of the Code .
Federal excise taxes . If However , you are not automatically exempt from other
Federal taxes , You have any questions about excise
please let us know , . employment , or other
Donors may deduct contributions to
Bequests , le You as `
gacies , devises , transfers provided r section 1 s of the Code .
deductible for Federal estate and or gifts to you or for
Provisions of sections 2055 , 2106 gift tax purposes if they meetotheur uae are
and 2522 of the Code , applicable i
The box checked in the heading of this letter shows whether
990 , Return of Organization Exempt from Income Tax . You must file Form
required to file Form 990 only if o If Yes is checked
than Your gross receipts each ' YOU are
$ 25 , OOo . If a return is required , it must be Piled b year are normall
month after the end oP Y more
Your annual accountingY the 15th day of the fifth
$ 10 a day , up to a maximum of $ 5 , 000 , when areturndisTfiledlaw
lim imposes
a
is reasonable cause for the delay * Penalty of
s there �
Client#: 5887 INDIARIV1
ACORD , .r CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODIYYYY)
06/12/03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Palmer 8r Cay of FL , LLC HOLDER . THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
1500 Mahan Drive , Suite 111
Tallahassee , FL 32308 INSURERS AFFORDING COVERAGE
INSURED
INSURER
#
SURER A. American Cas Co of Reading PA
Indian River Memorial Hospital
1000 36th Street INSI IRFR R National Union Fire Ins Co Pa
Vero Beach , FL 32960 IN SURFR ( ,
INSLIRLR U
INSURER F
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ,
I
LTR rNWSREI TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
GENERAL LIABILITY DATE MM/DD/YY DATE MM/DD/YY LIMITS
EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $
CLAIMS MADE OCCUR MED EXP (Any one person) $
PERSONAL A ADV INJURY
GENERAL AGGREGATE $
GEN'1. AGGRFGA IF I )MIT APPLIES PFR .
POI PRO_ PRODUCTS - COMP/OP AGG $
JECT I I IOC
AUTOMOBILE LIABILITY
COMBINED SINGt F LIMIT
ANY At ) l O ( Fa accident ) $
Att OWNFDAIITOS
RODILY INJURY 4
SCHFI ) f)I FI ) AIITO (Per person)
HIRFFI AUTOS
NON OWNFO Al llrls FIODII Y INJURY 4
( PPf IiC(:IdP.nI)
PROM RTY DAMAGE'
( Per acudenU $
GARAGE LIABILITY
AUTO ONL Y IFA AY;CIDF NT
ANY Al I TO
*
OIIiER 1HAN FA ACC
-
AUTO ONI . Y AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE $
OCCI IR ❑ CLAIMS MADE AGGREGATE $
DEDUCTIBLE
RF_ FF NTION $
$
A WORKERS COMPENSATION AND WC247857798 01 /01 /0301 /01 /04 W( . i TARI UTH
EMPLOYERS' LIABILITY LIM
ANY PROPRIETOR/PARTNER/FXFCtITIVF I: . L . EACHACCIDI- NF S1 000000
OFFICER/MF Milt R F XCI I IDFD"?
If yes, rfes( ow under E . I DISL- ASI LA f MPI. r)YEE $ 1 ,000 ,000
SPECIAL PROVISIONS below L . L. DI:F ASF Pf IL ICY LIMIT $ 1 , 000 ,000
B OTHER Medical Prof CNM7055124 12/01 /02 12/01 /03 $ 1 , 000 ,000
$ 3 , 000 , 000 Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Shared Limit
** Supplemental Name **
Indian River Memorial Hospital
Indian River Hospital District
Indian River Hospital Foundation , Inc .
( See Attached Descriptions )
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Indian River Memorial DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 _ DAYS WRITTEN
Hospital , Inc NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
1000 36th Ave IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Vero Beach , FL 32961 REPRESENTATIVES ,
rTIIORl7ED REPRESENTATIVE
At wACORD 25 2001 /08 .... 1' �✓,x..�t ( _. . t ;.N,'l'`� %l�..fl•�A/�Lr
A..
) 1 of 3 # S35512/M35510 21KPW w ACORD CORPORATION 1988
� RMHIndian
Lee M . Klinetobe
River Chairman, Board ofOirectors
OMemorial
• a .`oofts Hospital Jeffrey L . Susi
President, Chiel Executive Officer
We 're Here for Life
October 28 . 2003
Indian River Count \
Board of ' ( ' ounty ( ' OnunissioncrS
1840 25t ' Strcct
VcrO Beach , I4I , 32960
Re : ( ' anlh Manatee
Deal- MS . ,loll llstoll - Cal' 1soll :
The intent ol, this letler is to verify general liability insurance coverage fi ) r Indian River
Memorial hospital . Inc . ( IRMI I ) . IRMII ' s general liability insurance program hrcscnlly
consists of '.
• A Sell- insured retention ( SIR ) with coverage limits of $ 5 , 000 . 000
• An umbrella insurance policy issued by Admiral Insurance C' ompally ( Rated A +
VIII by A . M . Best and hart of ' thc Berkley Group olecompanies )
providing ccwcran ge ol , $ 10 . 000 , 000 in excess 01. 11- SIR Subject to aannual
aggregate of $ 10 . 00 ( 1 , 000 of claims paid .
• An excess liability insurance policy issued by Steadfast Insurance ( ' onlpany
( Rated A XV by A . M . Best and hart of ' ( hc lurich Group ) providing coverage of -
$ 10 . 000 . 000 in excess 01 ' our Admiral policy Subject to an annual aggregate of
$ 10 . 000 . 000 claims paid .
11C current 1)01ic } perlod is October 12 . 2003 to October 12 . 2004 . 1 trust that this
will
satisfy your reyucsl 1i0r insurance III liOrnlatloll rclaling t0 Indian River Memorial I lospital .
Inc . If you have any clucslions, regarding this nlalter . please call rlle al ( 772 ) 567 -431
1
extension 1153 .
Very ' frilly Yours .
Gregory 01� till
Director Financial Reporting
I UOO i o I I I _ lIIe I • V( . iu I > c , u 11. , I lurirl , i � 2c10O 772 . 507 . 4 11 "1 (,
7 72 . ') 0 .! .
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