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410 HISCOX INSURANCE COMPANY INC. (A Stock Company) <br />I" I I SCOX 233 North Michigan Avenue Suite 1840 Chicago Illinois 60601 <br />A- 20 i3 -1 -7q <br />Certificate of Commercial General Liability Insurance <br />This certificate is issued for informational purposes only. <br />It certifies that the policies listed in this document have been issued to the Named Insured. It does not grant any rights to <br />any party nor can it be used in any way to modify coverage provided by such policies. Alteration of this certificate does not <br />change the terms, exclusions or conditions of such policies. <br />Coverage is subject to the provisions of the policies, including any exclusions or conditions, . regardless of the provisions of <br />any other contract. such as between the certificate holder and the Named Insured. The limits shown below are the limits <br />provided at the policy inception. Subsequent paid claims may reduce these limits. <br />Named Insured. <br />Insurer Name. <br />Policy Number. <br />Type of Coverage <br />Policy Effective Date <br />Limits of Insurance <br />Each Occurrence <br />Cit Com <br />Hiscox Insurance Company Inc. <br />I UDC - 1377817- CGL -14 <br />Occurrence <br />September 15, 2014 <br />Damage to Premises Rented to You <br />Medical Expense: <br />Personal & Advertising Injury <br />General Aggregate. <br />Products /Completed Operations <br />Aggregate: <br />General Aggregate Limit applies per <br />Policy Expiration Date. I September 15. 2015 <br />$ 1.000,000 <br />F$100 .000 Any one premises <br />$ 5,000 Any one person <br />I$ 1,000,000 <br />$ 1000.000 <br />Products- completetl operations are subject to the General Aggregate <br />Limit <br />Policy <br />Description of Endorsements /Special Provisions <br />Not applicable <br />Additional Insured Status <br />I <br />Certificate holder maintains Additional Insured Status if this boxed checked. <br />This certificate does not grant any coverage or rights to the certificate holder. If this certificate indicates that the certificate <br />holder is an additional insured.. the policy(ies) must either be endorsed or contain spe -cific language providing the certificate <br />holder with additional insured status. The certificate holder is an additional insured only to the extent indicated in such <br />policy language or endorsement. <br />Cancellation <br />In the event of cancellation of any policy described above . the insurer will attempt to mail 10 days written notice to the <br />certificate holder prior to the effective date of cancellation. However . failure to do so will not impose any duty or liability <br />upon the insurer, its agents or representatives, nor will it delay cancellation. <br />CG DS 0101 10 Includes copyrighted material of Insurance Services Office, Inc... with Page 2 <br />its permission. C ISO Properties. Inc... 2000 <br />� <br />�� )/)`1G L V <br />