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DocuSign Envelope ID: C9AF5D7E-E8F1-4FC2-8917-EA301453E701
<br /> ,y'�.,-...�*s ALVAR54 OP ID: DF
<br /> 14^x."t'",,. DATE CMMIDSdIY'`YY'p
<br /> CERTIFICATE OF LIABILITY INSURANCE F
<br /> 1 0511912015
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> CERTIFICATE DOE'S NOT AFFIRMATIVELY OR NEGATIVELY AMEND„ EXTEND OR ALTER THE COVERAGE. AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder Is air ADDITIONAL INSURED, the poldcy(lesi must be endorsed, if SUBROGATION IS WAIVED, subject to
<br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder In lieu of such endorsement(s).
<br /> PRODUCER CIOS Inc COITICT
<br /> Main Street America Group o NAME EEE 671 –._-1-11111-P- Pr�oNE --
<br /> Po Box 20068 -, tic:NPl t3�51a-332477E
<br /> Southern Region 1AIC No
<br /> Keene,NH 0'3431 _... r msa Irau Cram
<br /> _ADDRESS:.servicecent,,.,, _..___ P . ........_..�..._-,. ---_...._.
<br /> Northeast Agencies Inc INSURERIsI AFFOROINC COVERAGE LAIC a
<br /> _.__. __ ......... ....._.m _....
<br /> INSURER A.Main' Street America Assurance 29939
<br /> __.._ _......_....
<br /> WNSURED Eloy Alvarez DBA INSURER B:
<br /> Galeanas Painting .. ___._.. ..___. ..... _
<br /> 5515 W Market St Apt 1806 INSURER r
<br /> Greensboaro,NC 274179-25'55 IaSURERD
<br /> INSURER E
<br /> INSURER F --
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED'ABOVE FOR THE POLICY PERIOD
<br /> INDI CATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER, DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSRT....... ------_---------_ -........w'AID SUM
<br /> ._,_....._,__.._. . '
<br /> LTR TYPE OF INSURANCE POLACY'NUMBER _ Ma.MAfDDPYYYY)l MM(C3rkPYYYY L.INiRa
<br /> A X COMMERCIAL GENERAL LIABILITY EACH Ghr v^G.fPPEaNq„IE ^S
<br /> ; ' 1,0..,.0,._0.
<br /> ,00
<br /> �„ T;ELR ? MPU1371P tP02f20115 014102'1201'6 2016 500,000
<br /> _._..._..............
<br /> MTlED EYR I Any on,)Na¢rsa,fq 'I 10,00
<br /> _ ....
<br /> PERSONAL&sr l INJURY__ .._t _1_-,_0_'1_.0.,
<br /> 00
<br /> GE N1 A.,.rEGA I LMIT ALMLIES PEI LNF RAI.
<br /> AGERFGRU'L' z 2,CXOLt,00...
<br /> F,wI.
<br /> 6 r�,_aLIL.Y rr+.T � .. p.ry
<br /> PRODUCTS � Iallaar AcG t 2,000,00
<br /> ari IEFI'
<br /> AUTOMOBILE LIABILITY" COMVIPI rL7SINGLE l mi'T $
<br /> E nrraArmn�. ... .........
<br /> A, AUT': P iCR Y III AJRY QF afi{, r.aE S
<br /> ..... __ ...........--- _.
<br /> SCHEDULED
<br /> AI tar'. NOS, %NNE.`;� 'ilL'M pB'�—D,A, 4{"'JE' i r a99 u
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<br /> UMBRELLA LIAB... u.r"tIJGt I:ACHr.'aCCa.RRENCF 9E
<br /> EXCESS LIA,e J {;LXJ G-MAAfCE AQT,MCP,,A f T
<br /> ETa wraT
<br /> ON t I
<br /> WORKERS COMPEINSA71ON PER
<br /> AND EMPLOVERS LIABILITY
<br /> A MNA' irr€i ¢P`I Aaarrarar dL rra.t'ttwE YIN WCU1'371P 04102f2015 0410212016 r 1, q Aa HAS '.'ICENr 6 1'0p 00
<br /> aPk fCAP'I4JI JC..�F I NIA ___.... ... .. .,._.......
<br /> (Mandatory In NH) ..._. E L D) EASE..EALnAY LGYE EI y 100,00
<br /> Ih"t rI swbii Incier -..-._ _
<br /> t.'L SC RuI TIFdN Q F UFIE,RA.T P J'rw 11+'rI�AN E C .EASE.P(YLI r'LlBw 00,000
<br /> DESCRIPTION OF OPERATIONS P LOCATIONS 4 VEHCLES, I'ACORD"IO',Addbkiona4 Rom arks Schedule,may be aatlAdTed I'r more space is megr.alredl
<br /> Orange County is named as Additional Insured,
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED, IN
<br /> Orange County ACCORDANCE WITH THEPOLICY PROVISIONS,
<br /> Pro BO'x 9181
<br /> HilisbrDugh, NC 27278 AUTHORITEDREPRESENTATIVE
<br /> 1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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