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A(;u,KUN CERTIFICATE OF LIABILITY INSURANCE D93Fj{yyf&" <br />PRODUCER (843)785-7733 FAX (843)686-4369 <br />Coastal Plains Insurance THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />5 Bow Circle HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Hilton Head Isl and , SC 29928 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Connie Dolan INSURERS AFFORDING COVERAGE <br />INSURED Professional Tennis Registry NAIL# <br />INSURER A: Capitol Specialty Insurance <br />P.O. Box 4739 <br />Hilton Head, SC 29938 A - 9`t006-096?- 01 <br />INSURER 8: <br />INSURER C: <br />INSURER D: <br />INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEEDp TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITH; <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTQR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS C <br />POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />NSR DD' TYPE OF INSURANCE <br />POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br />GENERALCOMMERCIAL <br />CS00217967/19113 01/01/2007 01/01/2008 EACH OCCURRENCE LIMITS <br />X COMMERCLAL GENERAL LIABILITY 1, 00U , OOQ <br />DAMAGE TO RENTED $ 100 <br />CLAIMS MADE a OCCUR <br />A MED EXP (Ary ono Verson) $ ,000 <br />5 , 00 <br />PERSONAL 8 ADV INJURY S 1 001 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />E <br />GENERAL AGGREGATE $ 2 001 <br />X POLICY JPRO- LOC <br />I �O <br />A <br />PRODUCTS - COMPIOP AGG $ 2 001 <br />AUTOMOBILE LIABILITY <br />ANY <br />A <br />AUTO <br />'dQ�+"O <br />COMBINED SINGLE <br />(Ea )$ <br />ALL OWNED AUTOS <br />� <br />SCHEDULED AUTOS <br />1� c ,fJ,'(C��G <br />4 ` P <br />G <br />BODILY INJURY <br />(Per $ <br />HIRED AUTOS <br />nt <br />^C��S <br />Person) <br />NON -OWNED AUTOS <br />�* <br />BODILY INJURY <br />(Per amdent) $ <br />PROPERTY DAMAGE <br />{Per accident) $ <br />GARAGE LIABILITY <br />ANY AUTO <br />AUTO ONLY - EA ACCIDENT $ <br />OTHER THAN EA ACC $ <br />EXCESSIUMBRELLA LIABILITY <br />CS00217910/19113 01/01/2007 01 01 8 <br />/ 200 <br />AUTO ONLY: AGG $ <br />X/ <br />OCCUR CLAIMS MADE <br />EACH OCCURRENCE <br />A <br />AGGREGATE $ 5 000 <br />DEDUCTIBLE <br />$ <br />X RETENTION S 1U , <br />$ <br />WORKERS COMPENSATION AND <br />$ <br />EMPLOYERS' LIABILITY <br />WC STATU- OTH- <br />ANY PROPRIETORIPARTNER,EXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />E.L. EACH ACCIDENT $ <br />P..OSI"Mier <br />SPECIAL <br />SPECIAL PROVISIONS beta <br />EL DISEASE -EA EMPLOYEE $ <br />OTHER <br />A <br />CS0021 <br />EL DISEASE L$ <br />Abuse/Molestation $100,00( <br />Per Occurrence/ $100,000 <br />DESCRIPTION OF OPERATIONS T LI7CATIONB / VEHICLES / <br />N7tCLUSgN3 ADD® BY ENDORSEMENT, SPECIAL PRovNSIONHS <br />Aggregate <br />Robert Manuel - Member # 50216 <br />Effective: January 6, 2007 <br />Robert Manuel dba HistArt H. Renaissance Institute <br />Tennis Society <br />Santa Ana, CA <br />ACORD 25 (2001/08) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCEL 1 M BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />30 DAYS WRITTEN NOTICE TO THE CERTIMATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MIME SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />OF ANY AND UPON THE INSURER, TTS AGENTS OR REPRESENTATIVES- <br />AUTHORIt7- REPRESENTATIVE <br />M.D. Barker, III/CAM <br />©ACORD CORPORATION 1988 <br />