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DocuSign Envelope ID:210FB50F-D15E-4627-BB63-FOBBF5AA7B2F <br /> DATE{Mh7/OD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 92,D4,2915 <br /> PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br /> Magu've Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 27101 Puerta Real Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR <br /> Mission Viejo,CA 92691- - ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. <br /> 877,438.7459 <br /> INSURERS AFFORDING COVERAGE NAIL# <br /> INSURED INSURER A:Ph?fade!ph?a Indemnity Insurance Company 18058 <br /> Steve Kim INSURER 8: <br /> dba:US Tae Kwon Do Center,Inc- INSURER C: <br /> 1S201 Rose Garden€n <br /> Du rha m,INC 27707-G800 INSURER D: <br /> INSURERf: <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 CERIFICATION 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 /> INSR ADD'L I POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRO -TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDJYYYYI DATE(MM,DD/YYYY) LIMITS <br /> A X GENERAL LIASIUTY PHPK539280-D05 03/05/2015 03/05,2016 EACH OCCURENCE $1,000,000 <br /> X COMMERCIALGENERALUASILNY Pfl El`ASES EaoccurrenCe 5100,000 <br /> CLAIMS MAOF �X OCCUR MED EXP(Any one person) $2,500 <br /> X PROFESSIONAL LIABILITY PERSONAL&ADV INtU RY $1,000,000 <br /> GENERAL AGGREGATE $3,900,000 <br /> GEM AGGREGATE LIMIT APPLIES PER: PRODUCTS—CO%1?10?AGG $3,900,000 <br /> X POLICY PROJECT LOC <br /> AUTOMOBILE LIABILITY COM$INED SINGLE LIMIT <br /> ANY AUTO - (EA accident) <br /> ALL OWNED AUT05 - BODILY INJURY <br /> SCHEDULED AUTOS {Per person} <br /> HIREDAUTOS <br /> BODILY INJURY <br /> NON-OWNEDAUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per acddent) <br /> GARAGE LIABILITY AUTO ONLY—FA ACCIDENT <br /> ANY AUTO OTHERTHAN EA ACC <br /> AUTOONLY; AGG <br /> EXCESS/UMBRELLA LIAM UTY EACH OCCURENCE <br /> OCCUR El CLAIMS MADE AGGREGATE <br /> DFTHJCTIRLE <br /> RETENTION <br /> EMPLOYERS'LIABILITY Y N TORYLIMJTS (E)RI H <br /> ANY PROPRICTORIPARTNERIEXECUTIVE <br /> OF HCER/A7EMSER EXC-,DED E-l.EACH ACCIDENT <br /> {Mandatory In NH) E.L DISEASE—EA AMPLOYEE <br /> if}}'es describe under . E.L.DISEASE—POLICY LIMIT <br /> SPECIAL PROVISIONS be?aw <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEH ICLES/EXCLUSIONS ADDED BY ENDORSEMENT f SPECIAL PROVISIONS <br /> It IS understood and agreed that the following entity is added as an addhlonal Insured but only with respect(s)to the operations of the named Insured except that liability resulting from the additional Inswed's sole <br /> negpgence. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE <br /> Orange County Attn:Risk Management THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE <br /> 2065 Cameron St,PO BOX 9181 CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DQ SO SHALL IMPOSE NO OBUGATtON OR <br /> Hillsborough,NC 27278- LIABILITY OF ANY RIND U PON THE INSURER,ITS AGENTS OR REPRESENTATIVES. <br /> AUTHORIZED REPRE$ENTATIVE <br /> ACORD 25(2009/01) © 1988-2009 ACORD CORPORATION.All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />