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CERTIFICATE OF LIABILITY INSURANCE 3 r2"r'i 0'16 <br /> 0 <br /> TMS CERTIFtCATE IS,ISSUED AS A MATTER OF IWORMATION ONLY AND CONIFERS NO RIGHTS UPON THE CERTIFICATE'ITIOLOE WTHIS 0 <br /> C <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY 41112 POLICIES 2? <br /> BELOW,THIS CERTIFICATE OF INSURANCE ODES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREII AUTIAORIZCD cc <br /> =1 <br /> REPRESENTATIVE OR PROQUCER,AND THE CERTIFICATE HOLDER. ITI <br /> =1 <br /> IMPORTANT.If the oerbfi holder is an ADDITIONAL INSURED,Cho policy(ios)roust bo endorsed,I(SUBROGA I ION IS WI U.subloot to < <br /> (D <br /> the terms and condibons,of the poticy.Certain pi may require an endorsement,A statement on thin cortificato door not confor dri[IR to tho 0 <br /> ceftf5--ate hotider In heu of such endorsenI (D�10 <br /> DO C <br /> ER ContractNaniii LanyCossio <br /> ITI <br /> Cz��In:surance Agency "64-608-1)ON 03 <br /> PO Box 188 �(Ai No,East) > <br /> SirrrpisonvdIi SC 29681 (.0 <br /> 00 <br /> (854)688-0121 0 <br /> INSUREH(S)AFFORDING GOVCRAGE NArC 0 <br /> NSURED INSURER A. NATION WIDEMUTUAL INS CO 6 <br /> n <br /> , M <br /> tinifiate-a-Party-com.INC INSURER B: Borli I Ila III hauion(x)Company <br /> 11781 US Highway 64 <br /> ITI <br /> Apex,NC 27523 'INSURER C: <br /> INSURER 11 4 <br /> INSURER Er <br /> 00 <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: C) <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAM ELI ABOVE rowaw Poticy PLna) wo <br /> INDICATED.NOTWITHSTANOINGANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUME."N't WITH ru-.,srux,.1 To vi ft'lls ITI <br /> CERTIFICATE-MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED Hll"IRFIN IS SUBJE C'1`10 At L THE IFRMS. CYI <br /> n <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, 00 <br /> INSR 17Y�EOF P6[CY...... -iU­8 POLICY NUMBER POLICY Err POLICY I 11MIT'S,.......... <br /> LTR INSR Wi (MWDDfyy) CMWDDrYY) <br /> X COMMERCIAL GENERAL LIABBJTY AbusoN olostation-Por Oc-ourronr*1 ExicAuded <br /> CLAIMS MADE OCCUR Products&Complotorl Oporritlono $1,000,000 <br /> Danigo to Promisas Ronii to You $3(KW),= <br /> General Ali(Other I Produals•C $5,1000.000 <br /> A TBD 41212016 4W2017 Each Occurronco $1,000,000 <br /> GENT.AGGREGATE LIMIT APPLIES PER Personal&Advertising injury $1,000,000 LCaC <br /> Legal Liability to Partial ants $1,000,1100 X POLICY PROJECT <br /> Prokoisional Linli(far Event Plann $1 000,00D <br /> OTHER. Doducliblo None <br /> AUTOMOBILE LIABILITY COMBINED SINOLE LIMIr $ <br /> ANY AUTO 0,OUILY IN,JURY JI'lar P 11 of 11 on $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS <br /> 'BODILY INJURY(Pair accklarfl $ <br /> HIREDAUTOS NOiWOWNED <br /> AUTOS <br /> PROPERIYOAMAGE $ <br /> (Per"cidonq <br /> -7 UMBRELLA LM OCCUR <br /> EXCESS LIAB CLAWS MADE <br /> ------------ <br /> DIED RETENTION S <br /> WORKERS COMPENSATION PER <br /> AND EMPLOYERS`LIABILITY STATUTE E R <br /> ANY PROPRIETORPARTNEWEXECUTIVE YIN <br /> OFFICE"EMBER EXCLUDED? N/A <br /> (Mau dataq,in NH) <br /> It yes,describe ur4er <br /> DC SCRI P nON OF OPERATIONS below <br /> Loss Period 90 days after the Covered Aocidoni <br /> Total Maxitnu In for All Acclidon I Mod Ion I s2s,oria <br /> B Acocent Math at <br /> PAILD12R0247001 41212016 411 AccidontDt)alt,i&Dlsmorribormotilaonr)t $25000 <br /> Appillos During par Covorodl Acci�onl <br /> Applios To Death&ClIsmomborroont Brawlits only <br /> DESCRIPTION OF OPERATIONS?LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schodulojif more spore Ill required) <br /> Party Equipaient Rentals Operations located at 11781 US Hwy 64 Apex,NC 27523.Vorilloation of Insurance Only <br /> Amusement devices on file with company.See Attached Inventory.Coverago Is excluded for Mechanical Bull,Rockwall,Trackless Train <br /> CERTIFICATE HOLDER CANCELLATION <br /> North Carolina Departrnent of Labor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES EIII CANCELLED BEFORE <br /> Elevator&Amusement Devices Bureau THE EXPIRATION DATE THEREOF,NOTICE WILL BL DEL.IVEREI)IN <br /> 1161 Mail Services Center ACCORDANCE WITH THE POLICY PROVISIONS, <br /> Raleigh,NC 27699 ED-R,EP I RES I ENTA I T I WE <br /> 0 11188.X114 ACORD CORPORATION.All rights reserved, <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />