HomeMy WebLinkAbout2010ACORD CERTIFICATE OF LIABILITY INSURANCE
9/3%2010 '
PRODUCER (800) 794 -0268 FAX: (772) 231 -4413
Brown & Brown, formerly Felten /HBA Insurance
2911 Cardinal Drive
PO Box 643488
Vero Beach FL 32964 -3488
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Boys & Girls Club of Indian River County, Inc.
P.O. Box 3068
Vero Beach FL 32964 -3068
INSURER A:Philadelphia Insurance Co
INSURER B: Florida Retail Federation
10700
INSURER C:
INSURER D:
INSURER E:
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.
AGi 3REGATE LIMITS H AV N REDUCED PAID IM
INSR
ADD'L
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM /DD/YY
POLICY EXPIRATION
DATE MMIDD
LIMITS
A
X
GENERAL LIABILITY
X
?qf ME RCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
PHPK470323
9/13/2009
9/13/2010
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 300 , 000
MEDEXP (Any one person)
$ 15,000
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY PRO- 7
JECT LOC
PRODUCTS - COMP /OP AGG
$ 3,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
PHPK470323
9/13/2009
9/13/2010
(Ea acccideD; INGLE LIMIT
$ 1,000,000
BODILY INJURY
(Per person)
$
X
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA A
AUTO ONLY: AGG
$
$
A
EXCESS /UMBRELLA LIABILITY
7X OCCUR FI CLAIMS MADE
DEDUCTIBLE
X RETENTION 10 000
PHUB284488
9/13/2009
9/13/2010
CCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER /MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
52025864
9/13/2009
9/13/2010
WC STATU- OTH-
X T RY LIMITS R
E.L. EACH ACCIDENT
$ 500,000
E.L. DISEASE - EA EMPLOYEEI
$ 500,000
E.L. DISEASE - POLICY LIMIT
$ 500,000
OTHER
DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS
Certificate Holder is included as Additional Insured with respects to General Liability.
The City of Sebastian
1225 Main Street
Sebastian, FL 32958
ACORD 25 (2001108)
IMCn,2r ,>,
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENr ° TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMEr
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
INJURER, ITS AGENTS OR REPRESEI
AUTHORIZED REPRESENTATIVE
i INSURANCE GROUP /MAR
0 ACORD I