2015-148-E DEAPR - Inflate-A-Party for Bounce House-Egg Hunt $1,167

Browse Search

DocuSign Envelope ID:61CAADBE-A7C0-40D3-B313-2E97E4C573F6 [ , -CERTIFICATE OF LIABILITY INSURANCE 3/412015 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 INSURER(S),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: I Jeff Kelly Cossio Insurance Agency Phone 9197402429 -Fax 1 SiOmpsonvg a,SC 29681 (AfC,No,Ext): AA/C,No}: {864)688-0121 E Mail: rentals @inflate-a-party.com INSURER(S)AFFORDING COVERAGE NA1C# INSURED INSURER A: United States Fire Insurance Company SPORTS AND RECREATION PROVIDERS ASSOCIATION - (PURCHASING GROUP)AND ITS PARTICIPATING MEMBERS: INSURER B: n ate-a- arty.com,INC INSURER 0: 11781 US HWY 64 _ Apex,NO 27523 INSURER D: INSURER E: COVERAGES CERTIFICATE NUMBER: USP148990 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEb 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 TYPE OF POLICY ADDL SUSR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVO (MMIDD/YY) (MMIDDIM X COMMERCIAL GENERAL LIABILITY Each Occurrence $1,000,040 CLAIMS MADE ❑OCCUR General Aggregate $2,000,000 Products/Completed Operations $2,000,000 Personal&Advertising Injury $1,000,000 A ❑ ® SRPGP-101-0414 4/2/2014 4121201S t=ire Damage $300,000 GEHL AGGREGATE LIMIT APPLIES PER Medical Expenses $5,000 X POLICY UPROJECT FILOC Deductible $0 OTHER: AUTOMOBILE LIABILITY COMBiNEDSINGLE LIWT L I ANY AUTO (Ea accident) ALL OWNED I-- SCHEDULED BODILY INJURY(Per Person) C1 AUTOS ! - AUTOS F]WREDAUTOS NON-OWNED BODILY)NJURY(Per aWdent) AUTOS ❑ PROPERTY DAMAGE (Per accident) ❑UMBRELLA LIA13 OCCUR ❑EXCESS LIAR CLAIMS-MADE DED ❑RETENTION$ WORKERS COMPENSATION PER OTH- AND EMPLOYE=RS'LIABILITY STATUTE ER ANY PROPRIETORIPARTNERrEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? L IN NIA (Mandatory In NH) If yes,describe under DESCRIPTION OF OPERATIONS below Accidental Death&Dismemberment $10,000 A Accident Med-cal US1 $0 78564 4!212814 412/2015 Maximum Benefit Amount $10,0 Deductible $p ....... DESCRIPTION OP OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Party Equipment Rentals Operations located at 11761 US Hwy 64 Apex,NC 27523. Certificate Holder As Additional Insured Amusement devices on file with the company for special event(s)dated 3/2812015 to 3/28/2015 located at 302 West Tryon Street,Hillsbofough,NC 27278. CERTIFICATE HOLDER: CANCELLATION ......... Orange County Risk Management SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 South Cameron Street ITHE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Hillborough,NC 27278 !'ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD