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DocuSign Envelope ID: D4EC3B36-C7FE-496E-A0C9-CDF8C55334AB <br /> DATE(MM/DD/YYYY) <br /> A CERTIFICATE OF LIABILITY INSURANCE 07/06/2015 <br /> PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br /> Maguire 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 I' <br /> Mission Vie(o,CA92691- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 877.438.7459 <br /> INSURERS AFFORDING COVERAGE • NAIC# <br /> INSURED INSURER A:Philadelphia Indemnity Insurance Company 18058 <br /> Martha Broda INSURER B: <br /> 1388 Manns Chapel Rd <br /> INSURER C: <br /> Plttsboro,NC 27312-7030 INSURER D: <br /> INSURER E: <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 POLICY EFFECTIVE POLICYEXPIRATION • <br /> LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS <br /> ' A X GENERAL LIABILITY PHPK1071271- 08/05/2015 08/05/2016 EACH OCCURENCE $1,000,000 <br /> © PREMISES COMMERCIAL GENERAL LIABILITY 002 DAMAGE(E RENTED $100,000 <br /> • O RENT occurrence) $ <br /> CLAIMS MADE © OCCUR ' MED EXP(Any one person) $2,500 <br /> PROFESSIONAL LIABILITY PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $3,000,000 <br /> GENT.AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG, $3,000,000 <br /> • <br /> X POLICY I I PROJECT n LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE UMIT <br /> ■ ANY AUTO (EA accident) <br /> ■ ALL OWNED AUTOS BODILY INJURY <br /> ■ SCHEDULED AUTOS • (Per parson) <br /> . HIRED AUTOS BODILY INJURY <br /> 111 NON-OWNED AUTOS <br /> (Peraccldent) <br /> ■ PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY—EA ACCIDENT <br /> ANY AUTO OTHER THAN EA ACC <br /> AUTO ONLY: AGG <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURENCE <br /> OCCUR I I CLAIMS MADE AGGREGATE • <br /> ■ DEDUCTIBLE <br /> RETENTION <br /> WORKE 5 C•MPENSATION AND I wcST MTS I I OM- <br /> EMPLOYERS' <br /> LIABILITY Y/N <br /> ANY OCCLUDED? I I E.L.EACH ACCIDENT , <br /> (Mandatory In NH) -- EL,DISEASE—EAAMPLOYEE <br /> If yes describe under (" <br /> SPECIAL PROVISIONS below E.L.DISEASE—POLICY LIMIT <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> It Is understood and agreed that the following entity Is added as an additional Insured but only with respect(s)to the operations of the named Insured except that liability resulting from the additional Insured's sole <br /> . negligence. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE <br /> THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE <br /> CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR <br /> ' LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. <br /> ( <br /> AUTHORIZED REPRESENTATIVE <br /> etrA 0 <br /> . <br /> ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION.All rights reserved. ( ■ <br /> The ACORD name and logo are registered marks of ACORD <br /> i# <br /> I <br />