Orange County NC Website
Browse       Search
DocuSign Envelope ID:6715A5E3-38C0-41CD-A4A6-DC9FD2F818D7 <br /> ACORD OF LIABILITY INSURANCE DATE(MM/OD/YYYY) <br /> 3/13/2016 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Sports&Fitness Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 212 Key Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Madison,MS 39110 <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INsuaRR A; Generai Insurance Company of America <br /> Nina Maier, <br /> INSURER H. <br /> 3302 Pearson Road <br /> INSURER Cz <br /> INSURER I: <br /> Hurdle Mills, NC 27541 <br /> INSURER F. <br /> COVERAGES <br /> °I'HE POW CIES OF INSURANCE Li5TBD BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD tNDIOATED, NC.YEWIThSTIUNG <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TIII5 CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN TS SUHJEC1" To ALL THE TERMS, EXCLUSIONS AND CONDITIONSSIKH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSIDD'L POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/OD/YY) DATE IMMI0D0rn LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE S 500,000 <br /> DAMAGE TO RENTED <br /> X COMMERCIAL GENERAL LIABILITY PREMISES (En occurence) `500(00G <br /> A LPF-9629940E (1/21/2016 4/21/2017 <br /> 1 CLAIMS MADE X OCT/1/1 , MED EXP (Any one pecEonl I p_8Q0 <br /> X Professional PERSONAL &AD5 INJURY TO X00,000 <br /> GENERAL AGGREGATE .; 1,001,010 <br /> GEN'I(AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGO $T,.000,011 <br /> PRO- <br /> POLICY (TECT LOC <br /> AUTOMOBILE LIABILITY <br /> . . <br /> 'COMBINED STEGIR LIMIT <br /> (Ed acci dent/ <br /> ANY BUTT) <br /> ALL OWNED AUTOS <br /> , ....._..._ 501)11,1 INJURY <br /> (rer person) <br /> SCHEDULED AUTUS <br /> MIRES AlTOS BODILY INJURY $ <br /> (Per accident) <br /> NON-OWNED AUTOS <br /> PROPERTY DAMAGE <br /> I Por n col dont I <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 1 <br /> ANY AM) EA ACC G <br /> (AUER THAN <br /> AUTO ONLY: <br /> AGO s <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE "( <br /> DEDUC7rIRLE, $ <br /> RICPENTLON $ $ <br /> WC STATIR - <br /> WORKERS COMPENSATION AND TORY 1,1Rig$I CT// <br /> EMPLOYERS'LIABILITY <br /> 2./,, EACH ACCIDENT <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ' <br /> OFFICER/MEMBER EXCLUDED? <br /> E.L. DISEASE - EA EmPLOY:d5 I <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L. /1/SP-ASE - POLICY LI,ST $ <br /> OTHER <br /> I <br /> I <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT(SPECIAL PROVISIONS <br /> Personal Trainers <br /> Certificate holder is named insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> Nina Maier DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> 3302 Pearson Road NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> Hurdle Mills, NC 27541 REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2001/08) 0 ACORD CORPORATION 1988 <br /> I <br />