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,a►co� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `....� 1 vv2oia 10/31/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certiflcate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may requlre an endorsement. A statement on this certiflcate does not confer rights to the certiflcate holder in Ifeu of such endorsement(s). PRODUCER Lockton Companies,LLC NTACT 3280 Peachtree Road NE,Suite#250 PHONE A/C No: Atlanta GA 30305 E-MAIL (404)460-3600 ADDRESS: INSURER S AFFORDING COVERAGE NAIC� iNSUReR n:Everest Indemni Insurance Com an 10851 INSURED pmerican Promotional Events,IRC. INSURER B: 1359576 DBA TNT Fireworks,Il]C. INSURER C: ITl 26743 P.O Box 1318 iNSUReR o.Berkshire Hathawa Homestate Ins Co 20044 4511 Helton Drive INSURER E:StBiI'S lus Lines Insurance Com an 13604 Florence AL 35630 INSURER F.�CIl S CC131 Insurance Com an 21199 COVERAGES CERTIFICATE NUMBER: 12080349 REVISION NUMBER: �CXXXXXX THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMELl ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TypE OF INSURANCE ADD SUBR POLICY EFF POLICY El(P LTR POLICY NUMBER MM/DD MM/DD ��M�TS A 6ENERALLIABILITY N N SI8GL00242-13t 11/1/2013 11/1/2014 DAMAGETO RENTED MMERCIAL GENE BILITY PREMISES(Ea occurrence) $ 3OO OOO CLAIMS-MADE �OCCUR MED EXP M one erson PERSONAI_8 ADV INJURY $ 1�OOO�OOO GENERALAGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCT,S-COMP/OP AGG POLICY PR� X LOC $ $ AUTOMOBILE LIABIIJTY N N SI8CA00012-131 11/1/2013 11/1/20t4 (Ea accident) $ X ANY AUTO 80DILY INJURY(Per person) 3 ALL OWNED SCHEDULED BODILY INJURY Per accident X HIR DSAUTOS X NON-OWNED PROPERTY DAMAGE $ XX��XXXX AUTOS $ XXXXXXX C X UMBRELLA LIAB X OCCUR N N EXC6023470-01 11/1/2013 11/1/2014 EACH OCGURRENCE $ S OOO OOO EXCES3 LWB CIAIMS-MADE AGGREGATE $ DED RETENTION$ g D WORKERS COMPENSATION _ AND EMPLOYERS'LIABILITY N ALW001224(AOS) 11/1/2013 11/1/2014 X TORY LIMIT ER D ANY PROPRIETOR/PARTNER/EXECUTIVE Y�N N�A •See below policies OFFICER/MEMBER EXCLUDED7 � E.L.EACH ACCIDENT $ (Mandetory In NH) E.L.DISEASE-EA EMPLOYE $ 1 �Q�000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ E Excess Liability(Starr) N N 1000010240 1]/1/2013 11/1/2014 $5,000,000 xs$5,000,000 p Excess Liability(Arch) UXP0056189-00 11/1/2013 11/1/2014 $10,000,000 xs$10,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (Atlach ACORD 101,Addkional Remarka Schedule,if more spacs is rcqulrod) *(G)(CA)Cypress Insurance Co; Workers Compensation:Policy#3 3000629 1 5-1 3 1,Policy Term: 11/1/2013-2014. (H)(OR)Continental Divide Insurance Co; Workers Compenation:Policy#ORW001321,Policy Term:1 I/]/2013-2014 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WRH THE POLICY PROVISIONS. 12080349 AUTHORIZED REPRESENTATIVE American Promotional Events d.b.a.TNT Fireworks 6255 SE 78th Street Ocala FL 34472 �G�� ,