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_CERTIFICATE OF LIABILITY INSURANCE 172.2.01
<br />THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW, THIS CERTIFICATE OF IN JUR.4NCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(51 AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER ` )ryed
<br />rO OR'TANf t e it,a rl7 r, rn ADD AL'VSJRPD It, p r ,e Aster error J.I oehof GA G l IS AI FD p �
<br />44>f"`5 ilnG Gndltl r6V p! hP JCII,., .SfiAI+ ni.TlC qs Ny r,y. 11 ,T.OY _n „I"I AsLltam.n n..4is -9rt -iN_.n eS "or "Y s, ] t,.^Ire
<br />cara0cam.' holder In seU of such sndorsenxo[+oL.
<br />.
<br />PRODUCER OOntE1Ct Yarf=l: Larry C0591G
<br />- ossio Irsurercn.Ager" 354-8838-0121 61,'d -e6.6-0138
<br />P4 Boz 178 A C N0. IE+t v ; 'r,
<br />S .... I vllle. SC 20GE1 'G-AM2iL Iammyt cessiolnsmalwo.com
<br />18641 +i68 -0'12t iNSURFRi31 AFFORDING COVERAGE NAICft
<br />NSUr$A INSURER A: NATIONWIDE MUTUAL INS CO 23787
<br />All StarJumper Renlal5. Li C INSURER 8- Berkley Life & Health Insolence Company
<br />- 117 North Standard Avenue, Suile A
<br />Santa Ana. CA )2701 INSURER C'
<br />INSURER D'
<br />INSURER E'.
<br />COVERAGES CERTIFICATE NUMBER. REVISION NUdMBER'.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LSTED SELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE: OR THE POLOY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REOUIREMEN T, TERM OR CONDITION OF ANY COIN FRACT OR OTHER DOCUMIENT WITH RESPECT TO A HIGH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
<br />EXCLUSaONS AND CONOITICNS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS,
<br />INSR TYPE OF POLICY ADOL SUER( POLICY NUMBER POLICYEFF POLICY EXP LIMITS
<br />LTR NISR YP/D 'MM CDrYYI MMDD-VY,
<br />_...... ..................._ -.. __- ___. -'-_ _-_ _---
<br />XCOMMERCIAL GENERAL LIABILITY ', fProducts uOdlYlp2t00Operations S1.0000001.000000
<br />lip0
<br />t CLAIMS MADEOCCUR _ Damage to PremRantod to You $300.000
<br />x' ises +Colonel4
<br />9S 10thar than Products -C $5.004000
<br />Each Occurrence $1.000.000
<br />A - FSVCCO000273666-00 3 23 2016 3,23,2017 ( Personal & Advehising "Jur $I 000OCO
<br />- GENLAGGREGA'E LIMA[ APPLIES PER - Legal Liahlllty to PXhuclpants $1,004000
<br />)( POLICY --PROJECT —'LCC
<br />-=ProFeSsonal domilty(tor Event Plana 51,000.000
<br />Dedacvdle None
<br />S OTHEF.. Paiminpant Acoldent - Exca5s Medical 510.000
<br />_ AUTOMOBILE LIABILITY 'I, COMBINED SINGLE LIMIT Ian
<br />ere acadann -
<br />-
<br />ANY AUTO -
<br />ALL OWNED SCHEDULED 30GILY INJURY PM ii -
<br />'AUTOS AHTOS
<br />HIRED AurOS NON-0SYNF_0y�`, BODILY INJJRrA a,CCFnt
<br />AUTOS �N i - PRG TY DAMAGE
<br />;\I1 _. 5 _.........
<br />�M� I /1 Para Je
<br />U
<br />UhIB16LLA10.6 CCCUF -
<br />EXCESS LIAR CILMIM5 MADE
<br />DED RETENTIONS
<br />....___ .. __..__ �
<br />WORKERS COMPENSATION ......._ _......... �i r� PER_-.OTH -. --
<br />AND EMPIO(FRJ LIABILITY "r �ry ('j �GQ - y,yt STATUTE ER
<br />- ANYPEOPLELORPARTNERPxccuTTVE YN "��p �` V np+e�a'�A\,1.� - — -... -
<br />-
<br />OFHCERMEMBEREXCLUDED' N/A
<br />fN �V/`
<br />M (TION , I NH
<br />DESCRiOrr P MCMI O'F OPERAr10Ns oeloa- ...... �✓
<br />........ -._... __ __._ ...-_. ._..._. ;._ -after - -.-_.
<br />'.�
<br />Loss Perorl SO Je,.eRer the [he Covered ,.r:..idont
<br />_ ' Total hlaatmum roc All Aceldent Meffc6
<br />al 52000
<br />6 - Aewm
<br />oae Vo$VJI PAI L012R0371001 3;232016 32..201"i Accdenl Death LC -s renlherzntrt 8enef £15,000
<br />Applies Durinry per Covered kc -dem
<br />'Agpfiesto Death& OPTernnermant Benents ore
<br />'- DESivRiPTION CF OPERATIONS: LOCATIONS VEHICLES (A1ach ACORD 101, Additional Remarks Senedule. if mare spore is'Hq Uir=_d;
<br />Party Eflnp i Rentals Ope,mvers Ioca;ed al 117 North Ca rodrcf A,, n s_ ate A Sarna Ana. CA ;)2.01. CanifIcI'e Holler ,s ii as Jc r1i5onal ri per form C G202b, The
<br />artitic :, holders added as an and ienal iesu: 1. Lot only for iAial Tt, caused. n N Vore at In part, a, the acts or ors ices of then rr d'I' Ured
<br />Amuselreet Jrior ITV; with fire-Jr1p4nyfo SPACRl-ecus. fated ihrocghUutthe oolicy period located of 20 ,c. 0,t rPdca-Santa V,a UAd1, .;9..,everage-saxc oido
<br />fur M1il...CHl BUII
<br />CERT=FICATE HOLDER'. CA.NCELLATI DO
<br />Cit, OfSesta Al-faOf!orto; pAgan A,d Reme>e,Chiias SHOULD ANY OF THE a811E DESCRBET POI CANCELLED BEFORE
<br />2 c Center Ka HE EXPIRA.iON DATE THERPOP. NOTICE 'I#LL 3E DE NERED IN
<br />Corp ane CA 9 791 AC'ORD E {PITH THE POI CY PPO °IONS.
<br />AUTHORIZED RuEEENTATIVE t - _.. _....
<br />'988-2014 ACORD CORPORATION All right; reserved
<br />ACOR'D 25 (201 4'011 The ACOP,D name and logo are registered marks of AGO FD
<br />
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