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DocuSign Envelope ID:F1B31172-6DD2-4B45-AEBD-1CA1925823FC <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE DATE/INIM/DD/YrYy) <br /> 4/42017 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Spouts&Fitness Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 712 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 <br /> INSTIR I A General 1.11E,UrEalc(I Company of Amer I ca <br /> Nina Mai er <br /> INSURER I): <br /> 3302 Pearson Road <br /> 12,1SURER <br /> INSURER D, <br /> Hurd'e Mills, NC 27541 <br /> INSE/112R <br /> COVERAGES <br /> THE 50.1, C E 1J3 INSURANCE T5TFD BELOW HAVE PEEN I 715)11'Fl TO THE INSURED ,NAM?:D AHOVL 1)1k 1'HE POLIO! PERIOD INDI OATT7,D. NOT PM II)T MING <br /> ANY REQUI'R EMEMr TERM OR COND ITYDN OF ANY CONTRACT OR OTHER. DOCUMENT WITH RES PECT TO WHICH THIS CERTIFICATE:: FIRS liE ISSUED OR <br /> MAY PERTAIN, TEE INSURANCE AFFORDED BY 'PEE POLICIES DESCRI.E3ED HERE:IN fYi SUBJECT To Al,!, ''HI' TERMS, EXCr,US IONS AND CONDITIONS <br /> SOLID ISO, AGGREGATE LIMITS SHOWN MAY LAO)' BEEN REDUCED 1YY PAID CLAI NIL <br /> INSRADD'LI POLICY EFFECTIvE pOLICy ExpiRATooN <br /> _LTRJNSRD TypE OF INSURANCE POUCY NUMBER DATE I MMIOGIYYJ DATE IMMiDD/Yn , LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE SOU,000 <br /> EAMAGE TO RENTED <br /> X MMFPC I JAB '"1 PREMISES (Ea 0c:ow:enc.) r 000 0 00 <br /> A -9F 4/21/2017 41/2 1/2018 <br /> , 01 MADE Ix (111•C1 LPF 629940 1110 uP 010y ca. Y)'lI 10 ,1101 <br /> X_ Prof es S I coal PERSONAL E.. ADV INJURY TO,Ill,!!! <br /> GENERAL ASCREGATE $ 2,000,000 <br /> C1.1,':,AGITICRWEE:LIIIIT APPT2Ts'G PRODUCTS - COMP/OP 1101'; $2 000,000 <br /> [ PRO <br /> POLICY I LOC <br /> AUTOMOBILE LIABILITY <br /> CCMEINEL SiNGUE LIMTT <br /> (Ea ECCC0 dent.. <br /> AN U70 <br /> Y A <br /> IN,T1r1 <br /> 1.3,,IM vrrs 0.1 <br /> HIRED Al!'OS BODIE1 INJURY <br /> (E'er ciccideaL) <br /> NON-OWNED AUTOS, <br /> PEORESTI lif,21/ESE <br /> (PE:r a227.iricnt <br /> GARAGELJABILDy AUTO ONES - EA ACC $ <br /> ANY AUTO EA ACC <br /> 1SV.1,1 <br /> AUTO NLY, <br /> ACEI <br /> EXCESstumBRELLA L IA4 ILTTY EACH occuRRE.rica <br /> ......... <br /> (Ill R SLPIMS MALE AG;RESATE <br /> : DSOUCTIELS <br /> 11.1 1174 <br /> WI'STATI/ <br /> WORKERS COMPENSATION AND <br /> EMPLOYERS'LIABILITY <br /> E.L. 'AIR ACCIDENT <br /> ANY PSCPRIETOR/PAETNER/RXEC=VE <br /> OPPICEE/mEmaRE EXCL)IaM? <br /> E.1. DISEASE - EA EMPLOY-0 <br /> 11 , ,I, II,' under <br /> SPECIAL ERCV1SIONS below E.L. DISEASE - POLICY $ <br /> oTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> Certificate holder is additional insured, <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> Linda Borkowski DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR To MAIL 10 DAYS WRITTEN <br /> 2824 Summerwind NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 50 SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR <br /> Chapel Rill, NC 27516 REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2001/08) 0 ACORD CORPORATION 1988 <br />