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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />INSURER(S) AFFORDING COVERAGE <br />INSURER F : <br />INSURER E : <br />INSURER D : <br />INSURER C : <br />INSURER B : <br />INSURER A : <br />NAIC # <br />NAME:CONTACT <br />(A/C, No):FAX <br />E-MAILADDRESS: <br />PRODUCER <br />(A/C, No, Ext):PHONE <br />INSURED <br />REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <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 />OTHER: <br />(Per accident) <br />(Ea accident) <br />$ <br />$ <br />N / A <br />SUBR <br />WVD <br />ADDL <br />INSD <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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 />$ <br />$ <br />$ <br />$PROPERTY DAMAGE <br />BODILY INJURY (Per accident) <br />BODILY INJURY (Per person) <br />COMBINED SINGLE LIMIT <br />AUTOS ONLY <br />AUTOSAUTOS ONLY NON-OWNED <br />SCHEDULEDOWNED <br />ANY AUTO <br />AUTOMOBILE LIABILITY <br />Y / N <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />DESCRIPTION OF OPERATIONS below <br />If yes, describe under <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />$ <br />$ <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. EACH ACCIDENT <br />EROTH-STATUTEPER <br />LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />EXCESS LIAB <br />UMBRELLA LIAB $EACH OCCURRENCE <br />$AGGREGATE <br />$ <br />OCCUR <br />CLAIMS-MADE <br />DED RETENTION $ <br />$PRODUCTS - COMP/OP AGG <br />$GENERAL AGGREGATE <br />$PERSONAL & ADV INJURY <br />$MED EXP (Any one person) <br />$EACH OCCURRENCE <br />DAMAGE TO RENTED $PREMISES (Ea occurrence) <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO-JECT LOC <br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />CANCELLATION <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016/03) <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />CERTIFICATE HOLDER <br />The ACORD name and logo are registered marks of ACORD <br />HIRED <br />AUTOS ONLY <br /> <br />1)3 3URSHUW\ &DVXDOW\ 6HUYLFHV 3ULPDU\ &DVXDOW\ <br /> ([HFXWLYH 'ULYH 3ODLQYLHZ 1<  <br />3XUYHV UHGPRQG OLPLWHG   8QLYHUVLW\ $YH 6 <br />7RURQWR 21 0- 0 <br />5,6. 0$1$*(0(17 <br /> <br />5LVN&HUWV#QISFRP <br />$&( $PHULFDQ ,QVXUDQFH &RPSDQ\ <br />$UFK ,QVXUDQFH &DQDGD /WG:DVWH ,QGXVWULHV 86$ //& <br /> %HQVRQ 'U 6WH  <br />5DOHLJK 1&  <br />;/ 6SHFLDOW\ ,QVXUDQFH &RPSDQ\ <br />1DWLRQDO 8QLRQ )LUH ,QVXUDQFH &RPSDQ\ RI 3LWWVEXUJ  <br />,URQVKRUH 6SHFLDOW\ ,QVXUDQFH &RPSDQ\ <br /> <br />$; <br />; <br /> <br /> <br /> <br />;; <br /><+'2* <br /> <br />$ <br />; <br />;; <br />,6$+ <br />% <br />&;; <br />; <br />8/3 <br />&$/,$ <br /> <br /> <br /> <br /> <br />;/LPLWV VKRZQ LQ &1' <br />$ <br />$; <br />1 <br />:/5& <br />6&)& <br /> <br /> <br /> <br /> <br /> <br /> <br />' <br />( <br />( <br />(TXLSPHQW ,QFOXGLQJ /HDVHG5HQWHG <br />&RQWUDFWRUV 3ROOXWLRQ <br />3ROOXWLRQ /HJDO <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />/LPLW 3HU 2FFXUUHQFH <br />2FF$JJUHJDWH <br />2FF$JJUHJDWH <br /> <br /> &1' <br /> &1' <br />$UFK ,QVXUDQFH &DQDGD /WG  $0 %HVW <br />2UDQJH &RXQW\ 6ROLG :DVWH 0DQDJHPHQW LV LQFOXGHG DV DQ DGGLWLRQDO LQVXUHG LQ DFFRUGDQFH ZLWK WKH SROLF\ SURYLVLRQV RI WKH *HQHUDO /LDELOLW\ 3ROLF\ DV UHTXLUHG <br />E\ ZULWWHQ FRQWUDFW <br />2UDQJH &RXQW\ 6ROLG :DVWH 0DQDJHPHQW <br /> (XEDQNV 5G <br />&KDSHO +LOO 1&  <br />DocuSign Envelope ID: 0EB6675A-A6D7-4838-849E-08BFF1564421