Agenda - 05-19-2015 - 6b - Laserfiche WebLink

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DocuSign Envelope ID: 3B2F6DD9-152F-419D-9A89-95AF3FCEEC72 17 INSURED monnaga America Foods, Inc. INSURERA:Tokio Marine 200 South Cameron Street Hillsborough, NC INSURER B: D: I THIS 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 LTR TYPE OF INSURANCE ADDLBRJ INSR M - POLICYNUMBER POLICY EFF (MMA)DIYYYYI POLICY EXP 1MM/DDIYYM LIMITS GENERAL LIABILITY EACH OCCURRENCE — $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY F_v_1 CLAIMS-MADE OCCLIR X CPPS407433 0512612014 0612612015 pR EMISES Ea 3ET0_RE9TEIT__ ( occurrence) $ 100,0 D[ MED EXP (Any one perac n) 5,00( PERSONAL &ADVINJUIRY $ 1,000,00C GENERAL AGGREGATE $ 2,000,0 OC GENT AGGREGATE LIMIT APPLIES PER: X1 POLICY O M F I LOC PRODUCTS - COMP/OP AGG $ I $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ — BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDU LED AUTOS PROPERTY DAMAGE (Per accident) $ HIRED AUTOS $ NON MED AUTOS X UMBRELLA LIAB OCCLR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE X 0176407430 05/26/2014 05126/2015 AGGREGATE $ 3,000,000 DEDUCTIBLE S X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE I— OFFICERIMEMBER EXCLUDED? NIA ITORY LIMITS _ER_ E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, Wescrite under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ . . . ............... DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is re -red) With respect to the insured's leased premises at 200 gou Cameron Street, Hillsborough NC, the certificate holder is included as Additional Insured subject to a Wr3.tt9n contract or agreement executed prior to a loss. HIR Manager Morinaga America Foods, Inc. P.O. Box 1359 Hillsborough, NC 27278-1359 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 (0 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2DO9109) The ACORD name and logo are registered marks of ACORD