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<br /> ��`'°'R°ffi CEi2TIFICATE G1F iABt�iTY 1NSURANCE °A�`�'°°'Y"""'
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<br /> THIS CERTIFIGATE IS lSSUED AS A MATTER OF tNFORMATtdN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HO�DER. THI3
<br /> CERTEFlCATE D4ES NOT AfiFIRN4ATiVELY QR NECaATNELY A ENd, EXTEND OR ALTER THE COVERAGE AFFORDEO BY THE PO�ICIES
<br /> BELOW. THfS GERTlFlCA7E OF INSURANCE QOES NOT CON TiTUTE A CONTRACT BETWEEN THE ISSUINCi INSURER(5), AUTHORIZED
<br /> REPRESEMTAI7VE Q!2 PRODUCEFt,AND THE CEi2TiftCATE HOLD R.
<br /> iMPOi2TANT: If the cartificate halder is an AtiDi'fidNAL iNSURED, e policy(ies�must be endorsed. If St1BROGATiON IS WAlVED,subject to
<br /> the tenns and conditions of the policy,certain policies may require an endorsement. A statement on this certfficate doe�not conter rights ta the
<br /> ceKlficata holder in lieu of sueh endorsement s.
<br /> �rtooueea NANE:
<br /> Brittan Galtsgher �
<br /> One Cieveiand Center,Fioor 30 eH.� - � �"°:
<br /> 1375 East 9th Street �ooRESS:
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<br /> CSeve{8ntf tJH 4d1 i 4 _^___._o+auaert�s�nF�or��NC coveance ___ r��uc�
<br /> IN3URERA./�(j r�Su�Ins Com anv ._, ,�...,_
<br /> INSURED �NSUneR a:Everest tm m�i in t�rance Co. __._._�__ ` 1
<br /> USA Halloween Planet Inc. I INSURER C.
<br /> dba USA Fireworks INSURER p: � �� �
<br /> 780Q Records St.,Ste.A -- —
<br /> (ndianepotis IN 46226 rNSUreeR�_____ ___
<br /> IN&URER F.
<br /> COVERAGES CERTIFICATE!+lUMBER:17�7g2 g7 REVlSiON FIUIVIBER:
<br /> THIS!S TO CERTIPY THA7 THE PQL#GtE5 OF INSUftANCE LtS1`ED SEE.O NAVE BEEN tSSUED 70 THE iNSURED NAMEO A60VE FOR 7HE POLICY PERIOD
<br /> � INQICATEO. NdTW17NSTANDiNG ANY REG1UlREMENT,TERM QR C4NDI IQN O�ANY C4NTRACT QR OTNER DOCUMENT WiTN FiESPECT FO WHICH THIS
<br /> CERTIFICATE MAY 8E ISSUE� OR MAY PERTAtN, THE lNSURANCE AFF QEQ BY THE PC7UGIE5 QESG12f@EO HEREIN IS SUBJECT Tt}AEL.THE TERMS,
<br /> EXCLUSIONS AND CONpiT�ONS qF SUCH POLICIES.L�MITS SHOWN MAY AVE 6EEN REpUCED BY PAID C�AlMS.
<br /> 7YPE OF IMSURANCE i POLICY EFF ' POUCV EXF uM�
<br /> LT'�R �iN R YWD FOUCY kUM R t hi1DO MN7D0
<br /> $ �C,ENERALIlA61t.[1'Y ! liainder �1120t4 'i12d15 �EACHOCCURRENGE �S1,OOO,q00
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<br /> ( �� i COMMERCIAL GENERAL UABILITY � ' Ii � i PREMISES tEa accurrencel �Qfl•4fl4 ,_,,,
<br /> J CLAtMS�MADE u OCCUR ( i ; i ! �MED EXP{Arty wet i�etsm) I S
<br /> i ! I � ' I P E R S 4 I V A L 8 A p V t N J U R Y �S 2,6 O O,0 0 0
<br /> f �--;-_ ____—; � , , i ___ i
<br /> _, f i f 1 GENERAL.AGGREOATE S2,000,000
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<br /> I PRODUC7S-CpMPiOP AGG 52,000,000
<br /> GENl AGGREGATE LIMY(APPLIES PER: ( I � I ! l �� __.,
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<br /> I � POI.ICY r� PRO- ��I LOC � � � i i S
<br /> f AUTOM08ILE LIABILITY ; � � �
<br /> �tEa acadent3_,�,"5
<br /> � i ANY At1'i'O � � � ( � 600i�Y MSURY{Par P�ani f S ��..�
<br /> ALL OVJNEd SCHEDULEO �
<br /> � ; �BOD{lY MJURY(Per accWmi)i S
<br /> AUTOS ������D i � {i } i �PFtOPERTY DAMAGE I E
<br /> � �HIRED AUTOS r�a AUTOS � 1 I i i � Per sccide�tl ,�..._..m_�..�.._.
<br /> � � a
<br /> � A UNBRELLALIA6 .X i�C�R � IEAU753068 �S11/2014 1(2015 i EACHdGCURRENCE 59�000,000
<br /> X ;EXCESSLIAB ��g.�{ppE j � i �AGGREGATE I 59,000,000
<br /> � (DED �R�.TENTION S � � � I S ^
<br /> I WORKER$CdNAEN8AT10N � WC STATU- � OTH-
<br /> AND EIHPLOYERS'UABILlTY V I N � iI I + I �TORY tiMY'fS� I ��_,.
<br /> I �ANY PROPRIET012PARTNEWEXECUTNE f ( 1 I � t E.�.EACH ACCIpENT i S
<br /> OFFICERlMEMBER EXCLUDED� ��N t A; i —��— ----'h--'—'""—'—'!��"
<br /> i �����y�ky} ( I ( I I �E.L.DI&EASE-EA EMPLOYE�E
<br /> � Ityas.describe undar � f
<br /> i �ESCRiPTIdN OF OPERATIONS 6dow � ' �E.L.DI5EASE-POUCV LIMfT�5
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<br /> ! OESCRiPTlON OF 4PERATIONS t IflCAS40N8!VEHtCIES{Aastiy AC4R4 t0{,Addttlonat Rtms ScheAule,#mme apace Ss rnqulredS
<br /> ; `*Rdditianat tnsured'#
<br /> i Stand�acation:Store#3761-?422 Ga{i Bivd.,�ephyrHilts, F�3354i
<br /> � 8tand Operatar's Name:USA Flailoween Pianet,inc. �
<br /> l.andowner's Name:Kmart Corporatian �
<br /> Additiona!lnsured_5ears Holding Management Corporation and iEs S+�bsidiaries and Affiliates are additionally+insured with respect ta
<br /> � Geneta!Liabiliky, `
<br /> Cross Suits Exctusion-insured Vs.Insured
<br /> CERTIFlCATE HpLDER CANCELl.ATION
<br /> SHOUL.D ANY OP THE A80Vf DESCit�EU P�..ICIES BE CANCELLED BEFBRE
<br /> � THE EXPtRATtQN DATE THEREOF, NflTiCE WILL 8E DEllVERED W
<br /> Kmart Corparation ACCORDANCE WITH THE POUCY PROYISIS7N5.
<br /> I Mail Stop A2-374B,3333 Beverly Road �
<br /> � Hpffman Estates IL 601�9 i AUTHUR¢EDREPRESEN7ATlVE
<br /> i i 't�kr��"'�.'.1��"
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<br /> i � (�1988-2010 AGORO CORPORATION. All rights reserved.
<br /> ACORD 25(201�/QS) The ACQ12D name and foga�are registered maHcs of ACORD
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