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® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/2013 Y) <br /> ACORO <br /> o7/r7/za13 <br /> PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br /> Marsh Dawson Insurance Agency,LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 5410 NC Highway 55,Sutie Al HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Durham,NC 27713 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 919-806.5109 <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: Nationwide Mutual Insurance Company <br /> Lynn Dunbar DBA Fun2Ref INSURER B: Riverport Insurance Company <br /> 1105 Infinity Road <br /> INSURER C: <br /> Durham,NC 27712-9795 <br /> INSURER D: <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INS ADD' POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIO LIMITS <br /> LTR INSR TYPE OF INSURANCE DATE MMIDDIYY DATE MMIDD/YY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000 <br /> X A COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 <br /> ^'X^� ACP GLGO 2215150455 08116/2012 08/1612013 <br /> ❑ ❑CLAIMS MADE III OCCUR PRODUCTS-COMPIOP AGG $ 2,000,000 <br /> ❑ - PERSONAL&ADV INJURY $ <br /> ❑ - DAMAGE TO RENTED f 300,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER MED EXP(Any one person) S 5,000 <br /> ® POLICY ❑JECT 0 LOC S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ❑ ANY AUTO (Ea accident) <br /> ❑ ALL OWNED AUTOS BODILY INJURY $ <br /> 8 SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS BODILY INJURY $ <br /> X NON-OWNED AUTOS (Per accident) <br /> ❑ PROPERTY DAMAGE $ <br /> ❑ (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ❑ ANY AUTO OTHER THAN EA ACC $ <br /> ❑ AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY ACP CAF 2215150455 06/16/2012 08/16/2013 EACH OCCURRENCE $ 1 000 000 <br /> ❑ OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 <br /> S <br /> ❑ DEDUCTIBLE S <br /> RETENTION $ $ <br /> B WORKERS COMPENSATION AND TORY LIMITS ER <br /> EMPLOYERS'LIABILITY WC-32-90-018509-01 06/3012012 08130/2013 E.L.EACH ACCIDENT $ 100,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 100,000 <br /> If yes,describe under <br /> SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> Certificate Holder is listed as Additional Insured for Liability. <br /> CERTIFICATE HOLDER CANCELLATION <br /> ADDITIONAL INSURED SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> Orange County DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> PO BOX S 181 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> �7 �7 p IMPOSE NO OBLIGATION OR LIABILITY OF A KIND UPON T SURER,ITS AGENTS OR <br /> 7�� <br /> Hillsborough,1V C 27278 2/O REPRESENTATIVES. <br /> 919-644-3042 AUTHORIZED REPRESENTATIVE <br /> 70 a M. Dawson <br /> ACORD 25(2001/08) 0 ACORD CORPORATION 1988 <br />