2014-423 Health - Functional Fitness to teach the exercise component $600

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CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYY`/) A CORDrM 05/28/2014 HIS 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. HIS 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 policy(ies)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 endorsement(s). PRODUCER CONTACT NAME: Mass Merchandising K&K Insurance Group,Inc. PHONE(A/C,No.Ext): 1-800-506-4856 IFAX(A/C,No): 1-260459-5590 1712 Magnavox Way Fort Wayne IN 46804 EMAIL ADDRESS: info @ftnessinsurance-kk.com INSURED 10042626 CP#1569 INSURER(S)AFFORDING COVERAGE NAIC# Functional Fitness,LLC INSURER A: Nationwide Mutual Insurance Company 23787 05 Eastowne Dr.,Suite C INSURER B: hapel Hill,NC 27514 INSURER C: Member of the Sports,Leisure&Entertainment RPG INSURER D: COVERAGES CERTIFICATE NUMBER:2000148082 REVISION NUMBER: HIS 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD MM/DD LIMITS 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 Ea occurrence $300,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $5,000,000 POLICY PROJECT F_�LOC OTHER PRODUCTS-COMPIOPAGG $1,000,000 PROFESSIONAL LIABILITY $1,000,000 LEGAL LIAB TO PARTICIPANTS $1,000,000 A 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 AUTOS BODILY INJURY(Per accident) X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident X Not proHded while in Hawaii UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION WORKERS COMPENSATION PER OTHER AND EMPLOYERS'LIABILITY YIN STATUTE ANY PROPRIETOR/PARTNER/ EXECUTIVE OFFICER/MEMBER E.L.EACH ACCIDENT 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 F PEPMTI N /LOCATION /VEHICLES(ACORD 101,Additional Remarks SChedule,maybe attached if 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 POLICIES 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 CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD