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ACORD® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY)

**/**/****

‘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

ccortficate holder in lieu of such endorsement(s).

PaoouceR Simply Business EET _ Simply Business

1 Beacon Street [acon 866-***-**** [ae na

Boston, MA 02108 EMAL ‘ad1jhw@r.postjobfree.com

INSURERS) AFFORDING COVERAGE nace

ingunemaz Spinnaker Insurance Company 4376

INSURED TS Construction INSURER 8

820 W Apache St INSURER C

Purcell, Oklahoma 73080 INSURER D

INSURER E

INSURER F

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

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 oot] susr] ‘POLICY EFF POLICY EXP

= TPE oF mouRANCe eae poucy nuween manele, Rane ums

A X x

COMMERCIAL GENERAL LIABILITY HBW3955459XB1 ——_fai14/202*-******* excu occurrence __ [$1,000,000

cuamsanoe [X ] occur PRNGERIEED [5100.00

MED EXP (Any one person) [85,000

PERSONAL aADVINsURY [51,000,000

(GENT AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE [$2,000,000

x Ro.

POLICY JECT Loc PRooucTs-compioracc [$2,000,000

TTOHSELETABIY Sonn

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UMBRELLA LIAB ‘occur EACH OCCURRENCE,

cuamousoe

apenee, AGGREGATE,

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PROFESSIONAL ABILITY AGH CLAM

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

Certificate holder is included as an additional insured on the General Liability policy per written contract.

CERTIFICATE HOLDER ‘CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

‘THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

Decked Out By Don, ACCORDANCE WITH THE POLICY PROVISIONS.

208 Doubletree Drive,

Venetia, PA 15367

"AUTHORIZED REPRESENTATIVE

(© 1988-2015 ACORD CORPORATION. All rights reserved.

‘ACORD 25 (2046/03) ‘The ACORD name and logo are registered marks of ACORD

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