NATIONAL ASSOCIATION OF STATE BOATING LAW ADMINISTRATORS (NASBLA) - 2016

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41,� o CERTIFICATE OF LIABILITY INSURANCE DATEh 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 certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Slade & Collins Insurance Agency NAME: T Tina Woofter 3320 Clays Mill Road Suite 109 Lexington, KY 40503 PHONE (659) 219-1121 FAX ac No, (859) 219-1125 E-MAIL tina@sladeandeollins.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Liberty Insurance 24062 INSURED NASBLA Mcn, KY 405ana P133kwy Ste 360 Lexington, Lexington, KY 405111338 INSURERS: Phoenix Insurance Company 25623 INSURER c : Travelers Casualty &Surety Co of AM 31194 INSURER D INSURER E INSURER F COVERAGES CERTIFICATF NIIMRFR- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 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 LTR TYPE OFINSURANCE ADDL SUER POLICY NUMBER POLICY EFF MWDD YY POLICY EXP MMODIYYY LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR BKS57763682 02/04/2018 02/04/2019 EACH OCCURRENCE $ 1,000,000 DAMA"TORENTED PREMISES Ea=urrence $ 1,000,000 MED EXP (Any one renemi, $ 15,000 PERSONAL &ADV INJURY $ GENT AGGREGATE LIMIT APPUES PER: POLICY PRO- JECT LOG GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGO $ 2,000,000 OTHER: AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT Ea accid.nl $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per ..Idertl,$ $ UMBRELLA LIM EXCESS LIAR OCCUR CLAIMS -MADE EACH $ AGGREGCURRENCE AGGREGATE $ DED RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? PER OTH- STATUTE ER $ B NIA UB7J28064917 12/04/2017 12/04/2018 E.L. EACH ACCIDENT $ 1,000,000 C (Mandatory in NH) DIt yEes.SCdeRIPTION un scribe under OPERATIONS below Directors & Officers 106669857 02/04/2017 02/04/2020 E.L. DISEASE - EA EMPLOYEE _ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe aaachad it more space is required) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE As Proof of Insurance Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD CORPORATION. All rights reserved, ..��r.�', (