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DocuSign Envelope ID:AE2871`51-01138-4E78-13810-3524813313BDE2 <br /> Clientilk 39383 38EXCELLANCEI <br /> DATE(pJ6VDDIYYYY) <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE 01/0412019 <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 certificate holder is an ADDITIONAL INSURED,the Erollcy(€as)must have ADDITIONAL INSURED provisions or be endorsed, <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may requiro an endorsement.A statement on <br /> this certificate does not confer any rights to the certificate holder in lieu of such endoreo3nottt{s). <br /> PRODUCER C +TACT <br /> Ir <br /> J Smith Lanier&Co-Huntsville rHOJvI` - FAQ <br /> tArc No,J�€;256 890-90001c pl�l_256 890 9070 <br /> Marsh&McLennan Agency,LLC E h41It <br /> P.Q.Box 6087 INSURERIS)AFFORDING COVERAGE NAIC# <br /> Huntsville,AL 35813-0087 -- <br /> ]PISURERA;��%�scf ts.sv,ad Vic run:l <br /> IIISURED _INSURER 8:F�ktr�st F�rylo�cn cacuxlty <br /> Excellence,Inc. - - -.-- <br /> INSURERC,_ <br /> 453 Lanier(toad INSURERD; <br /> Madison,AL 35758 - <br /> INSURER E <br /> IIISnRERF• - <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS 70 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR COND)T(ONOF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO 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 BEEN REDUCED BY PAID CLAIMS. <br /> INSR EFF POE€Cyy-E7€P' --Y <br /> n TYPEOFINSURANCE tISR LYVD POUCYNUMBER [ld;V110/YYFYp {h�VDaPYYYY). ._ LIMITS <br /> COMMERCIAL GENERAL LIABILITY EEAApC��H��OCC��UttRS�EN`CE 5 <br /> ._._._ nt <br /> CLAIMS-MIADE n OCCUR F'tiE f3S S1[ r ) 5 _ <br /> MED EXP(Any are p?man) I E <br /> PERSONAL&ADVINJURY IS <br /> CENLACCREGATE LIMIT APPLIES PER - GENERALAGGREG14P fS ., <br /> POLICY JE� LOC PROOMTS-CVAP10PAGG <br /> ]OTHER. <br /> 3 <br /> AUTOMOBILE LIABILITY CCk;€BJ"Fo slF,f=E IIFi.IT <br /> (Eaxkkntj,-- .� -a <br /> ANY AUTO DODiLY INJURY(Per person) -a - <br /> OhA.EO SCHEDULED BOOILYINJURY(Per accdarl) 5 - - <br /> AUrOSONLY AUTOS HIRED --- KON-AAA€EO PAC, Od'�Ar� S <br /> AUTOS ONLY AUTOS ONLY <br /> 5 <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE 3 <br /> EXCESSLIAD CL-NPi5-IAJ AGGREGATE 3 <br /> 4'tOMF ft$C0P.%PEN$ATl0N 191 <br /> A WC10000998002019A 1/01/2019 01/0112029 X STATLt7E...— <br /> AND EMPLOYERS'LIIA��BILITY Y r pS - <br /> B ANY <br /> PROPR114Et�REXCLNERIEUPFIY?ECUTIVEDN rrlA PPAL129001 1101/2019 0110112020 EL EACH ACCIDENT $1 000 000 <br /> 114andatory)nNN) EL (ASEASE-EAEa°PLOYEE $1,000000 _ <br /> If yos,dav-r1aa Under <br /> DESCRIP1104OFOPERATI0I15b0ay �_. EL DISEASE-POLICY LIMIT 1$1,000,000 <br /> DESCRIPTION OF OPERATIONS(LOCATIONS IVEHICLES iACORG 101,Additional Remarks Schedule,may he attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> For Proof of Insurance Only SHOULD ANY OF THE ABOVE DESCRI13EDPOLICIES BE CANCELLED BEFORE <br /> y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> O 1$. 615 ACORD CORPORATION.All rights reserved. <br /> ACORD 26(20161031 1 of 1 The ACORD name and Iogo are regEstered marks of ACORD <br /> #S4185168IM4185167 PZIR <br />