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DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550
<br /> ATE
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE o12/15/2020D/YYYv)
<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 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 /> PRODUCER CONTACT Randi K.Nowell,CPCU,ARM
<br /> MARSH USA,INC. NAME:
<br /> TWO ALLIANCE CENTER A/C NNo Ext: 404-995-3102 FAX
<br /> No),
<br /> 3560 LENOX ROAD,SUITE 2400 E-MAIL Marsh.comasscerts
<br /> ATLANTA,GA 30326 ADDRESS: Com p @
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> CN1 02832071-Compa-UMB1 0-20- CANTE CANTV INSURER A:National Union Fire Ins Co.of Pittsburgh PA 19445
<br /> INSURED INSURER B:AIU Insurance Co 19399
<br /> Canteen Vending Services
<br /> 1716 Camden Ave. INSURER C:ACE Property And Casualty Ins Co 20699
<br /> Durham,NC 27704 INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: ATL-005185847-01 REVISION NUMBER: 1
<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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY GL1728994 09/30/2020 09/30/2021 EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO TED
<br /> CLAIMS-MADE � OCCUR PREMISES
<br /> ('a
<br /> a occurrence)
<br /> ctcur ence) $ 1,000,000
<br /> X SIR:$1,000,000 MED EXP(Any one person) $
<br /> X Contractual Liability PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000
<br /> X POLICY❑ PRO-
<br /> POLICY ❑ LOC PRODUCTS-COMP/OP AGG $ 5,000,000
<br /> OTHER: I $
<br /> A AUTOMOBILE LIABILITY CA 4594426(AOS) 09/30/2020 09/30/2021 COEaMBINED accident SINGLE LIMIT $ 2,000,000
<br /> A X ANY AUTO CA 4594429(VA) 09/30/2020 09/30/2021 BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED CA 4594427(MA) 09/30/2020 09/30/2021 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> A X HIRED X NON-OWNED CA4594431(Garage Liability) 09/30/2020 09/30/2021 PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> Self Insured for Physical Damage $
<br /> X UMBRELLA LIAB X OCCUR X00 G27738631 09/30/2020 09/30/2021 EACH OCCURRENCE $ 10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
<br /> DED X RETENTION$0 $
<br /> B WORKERS COMPENSATION WC 045886802(AOS) 09/30/2020 09/30/2021 X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> B Y/N WC 045886807(CA) 09/3012020 09/30/2021 2,000,000
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> B OFFICER/MEMBER EXCLUDED? N/'4 WC 045886803 FL 09/3012020 09/30/2021
<br /> (Mandatory in NH) ( ) E.L.DISEASE-EA EMPLOYEE $ 2,000,000
<br /> B If yes,describe under WC 045886808(NY) 09/30/2020 09/30/2021 E.L.DISEASE-POLICY LIMIT $ 2,000,000
<br /> DESCRIPTION OF OPERATIONS below
<br /> A Liquor Liability GL1728990 09/30/2020 09/30/2021 Each Common Cause 1,000,000
<br /> SIR:$1,000,000 Aggregate 10,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> PO Box 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Hillsborough,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> AUTHORIZED REPRESENTATIVE
<br /> of Marsh USA Inc.
<br /> Manashi Mukherjee _lVi av�ao .h1J�K L
<br /> ©1988-2016 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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