2015-294-E Aging - Nancy Alton for Fitness Studio Management $6,000

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DocuSign Envelope ID:60F8978A-A70B-42DE-91 DB-3B1 3E5E1 F71 D A DATE ID CERTIFICATE OF LIABILITY INSURANCE 05/09/15D 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 Robert Kuchefski NAME: Hoffman Insurance Services,Inc. PHONE FAX 141 Linden Street A/C o Ext: 877-235 0406 ext.145 AIC No: 781-235 6665 PO Box 9002 E-MAIL ADDRESS: robertk@hoffmaninsurance.com Wellesley,MA 02482-9002 PRODUCER Phone:781-235-0087 CUSTOMER to M Fax:781-235-6665 INSURERS AFFORDING COVERAGE NAIL# INSURED INSURERA• Philadelphia Indemnity Company Nancy Alton INSURER B 3917 Markiyn Place INSURERC: INSURER D: Hillsborough NC 27278 INSURERS: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 TYPE OF INSURANCE ADDL 5 BR POLICY EFF POLICY EXP LIMITS LTR jM WVQ POLICY NUMBER MMIDD (MMIDPDOCM GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED AX COMMERCIAL GENERAL LIABILITY 8171 05/14/2015 05/14/2016 PREMISES Ea occurrence $ 100,000 CLAIMS-MADE a OCCUR X MED EXP(Any one person) $1,000 X Prof Llab Intl PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $3,000,000 POLICY Pft0 LOC I ABUSE&MOLESTATION $100,000/$300,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN LI T E ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe 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 required) Policy#: 8171 I Master Policy#: PHPK1282540 Program Information: ACE (e.g.ACE)I Member#:T7461a For a complete listing of coverage fors,please visit to www.lnsurePersonalTrainers.com/resources. NOTE:All premium is fully earned at inception of policy It is understood and agreed that the certificate holder is named as additional insured,but only as respects its liability arising out of the activities of the named insured. CERTIFICATE HOLDER See enclosed for Additional Insured CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN j ACCORDANCE WITH THE POLICY PROVISIONS. , f AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD