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i <br />f I <br />COVERAGES <br />THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO <br />DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER <br />HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />POLICY EFFECTIVE <br />POLICY EXPIRATION <br />LIMITS <br />INSR <br />OD' <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />EACH OCCURRENCE <br />S <br />GENERAL LIABILITY <br />DAMAGE TO RENTED <br />$ <br />— <br />COMMERCIAL GENERAL LIABIUTY <br />$ <br />MADE ❑ OCCUR <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />$ <br />CLAIMS <br />GENERAL AGGREGATE <br />S <br />PRODUCTS - COMP /OP AGG <br />S <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO- LOC <br />POLICY JECT <br />AUTOMOBILE <br />A <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />S <br />ANY AUTO <br />ALLOWNEDAUTOS <br />BODILY INJURY <br />(Per person) <br />$ <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />BODILY INJURY <br />(Per accident) <br />S <br />NONLOW NED AUTOS <br />PROPERTY DAMAGE <br />S <br />(Per accident) <br />GARAGE LIABILITY <br />AUTO ONLY - EA ACCIDENT <br />$ <br />EA ACC <br />$ <br />ANY AUTO <br />OTHER THAN <br />AUTOONLY: AGG <br />S <br />EXCESSIUMBRELLA LIABILITY <br />EACH OCCURRENCE <br />S <br />S <br />OCCUR CLAIMS MADE <br />AGGREGATE <br />$ <br />S <br />DEDUCTIBLE <br />S <br />RETENTION S <br />WC STWIT OTH- <br />WORKERS COMPENSATION AND <br />TOR <br />E.L. EACH ACCIDENT <br />$ <br />EMPLOYERS' LIABILITY <br />_ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />ANY PROPRIETOR /PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />AED2027940612 <br />06/19/2011 <br />06/19/2012 <br />$1,000,000 Each Claim <br />OTH <br />rXessional Liability <br />$2,000,000 Annual Aggregate <br />A <br />Claims-Made Form Full <br />$5,000 Deductible per claim <br />Prior Act <br />DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />ERTIFICATE H LDER <br />CANCELLATI N <br />DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />SHOULD ANY OF THE ABOVE <br />EXPIRATION DATE THEREOF; THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />*****SPECIMEN****** <br />OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES, <br />"C4fC0'' <br />*****SPECIMEN <br />'` ^ � ° �` ^ "y `. �� ", ;e <br />AUTHORIZED REPRESENTATIVE <br />SPECIMENY <br />Meade Collinsworth /ZO <br />ACORD 25 (2001/08) <br />O� ACORD CORPORATION 1988 <br />