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06/30/2016 10.28AM FAX 9192431010 Knight Insurance 00001/0001 <br /> t,reacea on: 1 rlursaay, ,rune 3Uth, 2016 at 10:23AM <br /> AC RIY CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOMYY) <br /> iih , OS/30/20'16 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES 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 corillftcato holder is an ADDITIONAL INSURED,the policy(Ios)must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policios may require an ondorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsemont(s). <br /> PRODUCER ; KNIfi,HT INSURANCE <br /> KNIGHT INSURANCE PNONND F..t-919-245-1020 —.1w,w):919-245-1010 <br /> 110 BOONE SQUARE ST,STE 7 MAIL <br /> ODRESS! <br /> HILLS130ROUGH,NC 27278 , INSURER(S)AFFORDINGCOVERAGE NAICti <br /> INSURERA; U.T#1 S S INSItiIAN . COMPANY <br /> INSURED INSURER 8. <br /> INSURERC: <br /> ORANGE TENNIS CLUB INSURERD: <br /> CIO ANGELA BAXLEY <br /> xiee COMM RUN ROAD INSURER E: <br /> EFLAND NC 27243 <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 /> INDICATED. NOTIMTHSYANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT YO 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 DE9N REDUCED BY PAID CLAIMS. <br /> LtR TYPE OF INSURANCE AVW6 K <br /> POLICY NUMBER MMlOD POLiCYEXP LIMRfi <br /> o:NcALLaBLT EACH $1,000-000 A 09/14115 09/ ) <br /> X COMMERGIALCENeRALLIABILITY SE5 EstCCxronco $ 0,0 <br /> CLAIMS-MADE Fx]OCCUR MED EXP Any ane pemon 6 <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE T $,2M0,000 <br /> GEML AGGREGATE LIMIT APPLIES PER _ <br /> PRODUCTS-GGMPlCPAGG $ <br /> POLICY PRO LOC S <br /> AUTOMOBILE LIABILITY MBIN�tSINGLE LIMI <br /> ANY AUTO BODILY INJURY For petann) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Paraccident) S <br /> AUTOS N1N40WNED PROPERTY DAMAGE $ <br /> HIRED AUTOS ALITOS oddent <br /> $ <br /> UMBRELLA UAO OCCUR EACH OCCURRENCE $ <br /> EXCESS UAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WDRKERscommNSATION WC5TATU. qTH- <br /> AND EMPLOYERS'LIApILITY CRY LIM <br /> ANY PROPRIETORIPARTNERIEXECUTIVE YIN NIA E.L.EACH ACCIDENT S <br /> OFRCERRAEMBER EXCLUDED? <br /> {Mandatory in NH) -EL DISEASE-EA EMPLOYEE$ _ <br /> If yea,deactibe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTitNI or OPERATIONS I LOCATIONS i VEHICLE$(Attach ACORD 902,Addidaaa:Rwnarlte Setleduia,if more apnea,required) <br /> TENNIS CLUB <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> �� �Q 1311 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS, <br /> HILLSBOROUGH, NC,27278 <br /> AUTHOR¢EO REFRE$eNTATWF <br /> 01988-2840 ACORD CORPORATION, All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />