2014-373 Aging - Functional Fitness, LLC for strength training classes $14,990

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y f . ACORD,,. CERTIFICATE OF LIABILITY INSUR DATE(MMIDDlYYYY) LANCE 05/28/2014 4HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW S CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSLIRER(S), AUTHORIZE .ePRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. MPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the ,,arms 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 endorsement(s). PRODUCER CONTACT NAME: Mass Merchandising K&K Insurance Group,Inc. PHONE(A/C,No.Ext): 1-800-506-4856 FAX(AIC,No): 1-:?60-459-5590 1712 Magnavox Way Fort Wayne IN 46804 E-MAIL ADDRESS: info@fftnessinsurance-kk.com INSURED 10042626 CP#1569 INSURER(S)AFFORDING COVERAGE NAIC ti Functional Fitness,LLC INSURER A: Nationwide Mutual Insurance Company 23787 05 Eastowne Dr.,Suite C INSURER B: Chapel Hill,NC 27514 INSURERC: Member of the Sports,Leisure&Entertainment RPG INSURER D: COVERAGES CERTIFICATE NUMBER:2000148082 REVISION NUMBER: HIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE FOLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH"-HIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS O SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DD MMIDD A X COMMERCIAL GENERAL LIABILITY 6BRPG0000005361800 08/21/13 08/21/14 EACH OCCURRENCE $1,000,000 CLAIMS-MADE �X OCCUR 12:01 AM 12:01 AM DAMAGE TO RENTED PREMISES Eaa rrence $300,000 MED E:XP(Anyone 3erson) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 POLICY 71PROJECT F_�LOC PRODUCTS-COMPeOP AGG OTHER $1,000,000 PROFESSIONAL LLkBIUTY $1,000,000 LEGAL UABTOPARTICIPANTS $1,000,000 AUTOMOBILE LIABILITY 6BRPG0000005361800 08/21/13 08/21/14 COMBINED SINGLE LIMIT 12:01 A.M. 12:01 A.M. (Ea Accident) $1,000,000 ANY AUTO BODILY INJURY(Per person) ALL OWNED AUTOS SCHEDULED BODILY INJURY(Por accident) UTOS X HIRED AUTOS kSNON-OWNED PROPERTY DAMAGE X Not provided while in Hawaii UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAR HCLAIMS-MADE - AGGREGATE DED RETENTION WORKERS COMPENSATION PER OTHER AND EMPLOYERS'LIABILITY Y/N STATUTE ANY PROPRIETOR/PARTNER/ � E.L.EACH ACCIDE AT EXECUTIVE OFFICER/MEMBER EXCLUDED. N/A E.L.DISEASE—EA EMPLOYEE (Mandatory In NH) If yes,describe under DESCRIPTION OF OPERATIONS E.L.DISEASE—POLICY LIMIT below MEDICAL PAYMENTS FOR PARTICIPANTS PRIMARY MEDICAL EXCESS MEDICAL DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached'rf more space is required) Location#1:605 Eastowne Dr.,Suite C,Chapel Hill,NC 27514 Facility Square Footage:2,375 On-site&Off-site coverage Professional liability is not provided for independent instructors. **This certificate voids and replaces certificate#2000112764** CERTIFICATE HOLDER CANCELLATION Evidence of Coverage SHOULD ANY OF THE ABOVE DESCRIBED POLICIE: BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Coverage is only extended to U.S.events and activities. **NOTICE TO TEXAS INSUREDS:The Insurer for the purchasing group may not be subject to all the insurance laws and regulations of the State of Texas. ACORD 25(2014/01) ©1988-2014 ACORD CORPORA710N. All rights reserved. The ACORD name and logo are registered marks of ACORD