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A� D® CERTIFICATE OF LIABILITY INSURANCE DA6/29/2017�) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements . PRODUCER Anthony Insurance Services, Inc. P.O. Box 927 Edwards, C081632 www.AnthonylnsuranceSarvices.com CONTACT NAME: NO PA/C NNE o Eat: AAIC No: ADDRESS: Caitlyn@anthonyinsuranceservices.com INSURERIS) AFFORDING COVERAGE NAIC0 INSURERA: U.S. Fire Insurance Company 21113 INSURED SPORTS AND RECREATION PROVIDERS ASSOCIATION(PURCHASING GROUP) AND ITS PARTICIPATING MEMBERS: INSURERS: INSURERC: HISTORY THROUGH THE EYES OF WOMEN DEBORAH MCINTOSH INSURERD: INSURERE: 23454 DARCY LANE INSURERE: NEWHALL, CA 91321 UUVEHAGES CERTIFICATE NUMBER: USS350OR9 OMIMIAM MITUMeo• THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR I TYPE OF INSURANCE AODL INSR SUER LNID POLICYNUMEER POLICY EFF IMMIDWYYYI POUCYEXP flauuormYmLIMITS GENERALLIABILITY GENERALAGGREGATE E 1.000,000 X wMMERCIPI GENERAL DPBMTY PRODUCTS - COMP/OP AGG s 1,000,000 PERSONAL S ADV INJURY 5 LOMP00 cWMs MADE �acclw p SRPG-101-0717 7/:01 17 EACNOCCURRENCE 12:01 AM A 2:01 12:01 AM s 1,000,000 FIRE DAMAGE (Any one fve) $ 3DO,000 CEN'LAGOREGATE LIMIT APPLIES PER MED EXP(Any one person) $ 5,000 X POLICY JECT 7 Loa AUTOMOBILE LIABILITY OMBINEEDD SINGLE LIMITffs-cul $ ANYAUTO BODILY INJURY (Per person) $ AUOWNED OCKOULED BODILY INJURY (Per evident) s AUTOS AUTOS WREDAUTO NG300GWNED ` 41�•° PROP.dd.nq MACE V Per ectleem $ $ e LJUMBRELLA LIAB LJ OCCUR ^ e T� EACH OCCURRENCE $ EXCESS LIAR I CtAIMSMAOE q�j V AGGREGATE IS OEO I RETENTION a $ • �Y , `• WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN a, C\�\ yVC STATLL ToRY IIMITS orry $ ANY PROPRIETOmPARTNERADtECUfIVE cr v Eft E.L. E.L. EACH ACCIDENT $ OFRCERKAEMBER EXCLUDE))) NI ^GJ (Mandatory In NH) C E.L. DISEASE - EA EMPLOYEE IS ntt•.ae•vme unaer El- DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS csw AO&D MAXIMUM MEDICAL DEDUCTIBLE TERMS OF PAYMENT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACOR0101, Additional Remarks Schedule, if mom space Is required) Covered Performer Type: Historical Portrayal, Proof of Insurance, HISTORY THROUGH THE EYES OF WOMEN DEBORAH MCINTOSH 23454 DARCY LANE NEWHALL, CA 91321 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE AvL>ji-" In,c Lra*Lu, Service V 15Stl-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD