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Rpr 22 2014 1: 25PM LEWIS+FORREST 919-732-6328 P- 1 <br /> co CERTIFICATE OF LIABILITY INSURANCE DAM1d <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF-INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICAM HOLDER,THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DIGES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURtEWS), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> WPORTANT; H the certificate holder ism ADDIT'ONAL INSURED,the pol"les)must be endo'sod. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain PON:Me may require an endoniement. A statemsnton this cerllticats does not confer rights to the <br /> certificate holder in lieu of such endorsemen s. <br /> PRODUCER N AAI Lewis&Format 'I <br /> AAI Lewis&Forrest PMONE 919732-2697 IFEC,N : 819-732.6328 <br /> PO Box 939 . rlleyd10@nIktionwide.6om <br /> Hillsborough,NC 27278 rM1KER;(&AFMR01NQCOnU9j rU11C0 <br /> INSURER . Nationwide Fire Insurance Cam <br /> INSURED IN RER e; <br /> Jet Junction dba LaPlace IN RERC; <br /> 111 N Churton St. INSURER D; <br /> HBlsborough,NC 27278 INSURERE: <br /> IN&WER P: <br /> COVERAGES CERTIFICATE NIUMISI iR: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURARCE LISTED BELOW HAVE BEEN ISSUED TO THE 1 VSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR O—HER DOCUMENT\MTH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TH? INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LlmiTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> TrPE OF 10MRANCE wrin NUMBER IPPAOU89WA 7132=2014 UNITS <br /> X COMMERCULGENERALLMIBILITY - EACH OCCURRENCE ; 1,000,000 - <br /> A CLAW MADE,GE O OCCUR ACP 2225592240 511 3/2013 s 300000 <br /> MEDEXP Ong me person 6,900 <br /> PERSONAL a AM INJURY $1,000,000 <br /> GENI AGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE S 2,000,000 <br /> Jt <br /> POLICYa ❑LOC PRODUCTS-cormopAm s 2p00,000 � <br /> OTHER: $ <br /> AUTGNOINLELLAKAMW Y p - S <br /> ANY AUTO BODILY IN JURY(Per person) S <br /> ALLOWNED SCHEDULED BODILY INJURY(Per GwJ&M S <br /> ryryuupQ AA <br /> AUTOS <br /> HIRED AUTOS AUTNOS Eb s S <br /> S <br /> UMSRB.LALUIB OCCUR EACH OCCIRREW E S <br /> @YCPSSUaa CLNMS4AADE AGGREGATE S <br /> DED RETENTION S <br /> PER <br /> WOMUMS COMPENSATION R <br /> AND EMPLOYERS•LIARI-IN <br /> ANY PROPRIETORIPARTNEREXECUTIVE YO NIA E.L.EACH ACCIDENT S <br /> OFFIO MEMBER EXCLUDED? ' <br /> Waacloory in NN) E.L.DISEASE.EA EMPLOYE S <br /> Ayse��aeamw rawer <br /> DESCRIPTION Cf PERATION8 below E.L DISEASE-POLICY LIMIT S <br /> DOW RVnONOFOPERATIONSILOCATONSIVOUMM(ACORD joe,AddBOns1 Rmnarks Schands,may teauacW Nmmaspas is r■ Arad) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County <br /> PD Box 8181 SHOULD ANY OF THE AE:OVE DESCRIBED POLICIES M CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Hilleborough,NC 27278, ACCORDANCE WITH THE POLICY PROVISIONS. <br /> T919-245-2564 AuTHDr:Ix�fa>�ESPMATN[ <br /> F 919-64A3008 <br /> ®1 -2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACCRD name and logo we registered marks of A CORD <br /> , ■ n .I n <br />