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,eco CERTIFICATE OF LIABILITY INSURANCE <br />`/1 12/23/2015 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CONTACTBWI Program Support <br />Veracity Insurance Solutions, LLC. <br />PHONE .N I IBM (888)568-0548 FAX $M: 801-763-1374 <br />info@insurebodywork.com <br />INSURERRM AFFORDING COVERAGE NAM <br />260 South 2500 West, Suite 303DRESS: <br />Pleasant Grove UT 84062 <br />INSURER A: GreatAmerican Alliance Insurance Company 26832 <br />INSURED <br />INSURER 8: <br />NSURERC: <br />chunxing lin <br />INSURER D: <br />INSURER E: <br />3937 foxglove ct n <br />brooklyn park MN 55443 <br />MSUREt F: <br />f <br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICY EFf POLICY IXP <br />MARI MMNO <br />UNITS <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY�r <br />EACHOCCURRENCE S 2,000,000 <br />PREMISESEaam�mnca�f 300,000 <br />X CLAIMS -MADE OCCUR <br />f ^ <br />f <br />MEDEXP(Mymepenon) E 5,000 <br />A <br />PL3842262-BW1036278 <br />10/21/2015 10/21/2016 <br />PERSONALSADVINJURY f INCLUDED <br />3 <br />GENERAL AGGREGATE f .000,000 <br />APPLIES PER: <br />PRODUCTS-COMPIOPAGG'$ 3,000,000 <br />TGEN'LAGGREGATELIMIT <br />X POLICY PRO L� <br />E <br />AUTOMOBILE <br />LIABILITYF <br />F <br />COMBIIaEEDD SINGLE LIMITisaiE - <br />--I <br />ANY AUTO <br />ROALYINJURY(Parpanax) $ <br />ALLOWNED SCHEDULED <br />AUTOS AUTOS <br />-—_�------____-� <br />BODILY INJURY Peracwanq$ <br />NON -OWNED <br />HIREDAIITOS AUTOS <br />POPER Y <br />PROPERLY DAMAGE <br />E <br />S <br />UMBRELLALIAR <br />OCCUR <br />FIF <br />EACH OCCURRENCE <br />is <br />EXCESS USE <br />CLAIMB-hMDE <br />AGGREGATE <br />$ <br />DED RETENTIONS <br />S <br />WORKERS COMPENSATION <br />ANO EMPLOYERS' UJIMUfY YIN <br />ANY PROPRI TOMPAM14EIVEXECUTNE <br />r <br />WC STATU- OTH-i <br />TORY LIMITS ER_y_, <br />_ -- <br />EL. EACH ACCIDENT <br />OFFICEMEMBEREXCLUDED? ❑NIA/ <br />_�$ <br />EL DISEASE - EA EMPLOYEE <br />$ <br />(Mantlaruyln NNl <br />DENN War <br />DESCRIPTION <br />EL DISEASE-PCKUMYLIMIT <br />S <br />A <br />Professional Liability <br />�' PL3842262-BW1036278 <br />10/21120151'110/21/2016 <br />INCLUDED <br />DESCMPIIONOFOPERARDMILOCATIONSIVEHICLES(ANaMACORD101,A1MM Remarks Schetlula,Nmmep HMRuWI <br />his understood and agreed thatthe Certificate Holder is named as Additional Insured per attached CG 20 26 - Additional Insured - <br />Designated Person or Organization subject to all policy terms, conditions, and exclusions. <br />CERTIFICATE HOLDER CANCELLATION <br />Q 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010705) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Jo Massage <br />Y 9 <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />19242 Evans Sl NW <br />Elk River MN 55330 <br />AUTHORIZED REPRESENTATIVE <br />Q 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010705) The ACORD name and logo are registered marks of ACORD <br />