ACORD CERTIFICATE OF LIABILITY INSURANCE …

1 TMANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMB ER EXCLUDED?INSR ADD LLTRINSRDDATE (MM/DD/YYYY)PRODUCERINSUREDPOLICY EFFECTIVEPOLICY EXPIRATIONPOLICY NUMBERLIMITSDATE (MM/DD/YY)DATE (MM/DD/YY)TYPE OF INSURANCEGENERAL LIABILITYAUTOMOBILE LIABILITYGARAGE LIABILITYEXCESS/UMBRELLA LIABILITYWORKERS COMPENSATION ANDEMPLOYERS LIABILITYOTHERDESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONSSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIONDATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAILDAYS WRITTENNOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.

2 BUT FAILURE TO DO SO SHALLIMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS REPRESENTATIVEINSURER A:INSURER B:INSURER C:INSURER D:INSURER E:EACH OCCURRENCE$DAMAGE TO RENTEDCOMMERCIAL GENERAL LIABILITY $PREMISES (Ea occurence)CLAIMS MADEOCCURMED EXP (Any one person)$PERSONAL & ADV INJURY$GENERAL AGGREGATE$GEN L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$PRO-POLICYLOCJECTCOMBINED SINGLE LIMIT$(Ea accident)ANY AUTOALL OWNED AUTOSBODILY INJURY$(Per person)SCHEDULED AUTOSHIRED AUTOSBODILY INJURY$(Per accident)NON-OWNED AUTOSPROPERTY DAMAGE$(Per accident)AUTO ONLY - EA ACCIDENT$ANY AUTOEA ACC$OTHER THANAUTO ONLY.

3 AGG$EACH OCCURRENCE$OCCURCLAIMS MADEAGGREGATE$$DEDUCTIBLE$RETENTION$$WC STATU-OTH-TORY EACH ACCIDENT$ DISEASE - EA EMPLOYEE $If yes, describe DISEASE - POLICY LIMIT$SPECIAL PROVISIONS belowTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED ORMAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCHPOLICIES.

4 AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIONONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEHOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES AFFORDING COVERAGENAIC #COVERAGESCERTIFICATE HOLDERCANCELLATIONACORD 25 (2001/08) ACORD CORPORATION 1988 ACORDCERTIFICATE OF LIABILITY Nuccio & Associates, Riverside DriveToluca Lake, CA 91602440757157130757157135/7/20115/7/201 15/7/20125/7/201205/06/2011$1,000,000$10 0,000$5,000$1,000,000$2,000,000$2,000,00 0 Proformance4 Johns LaneTopsfield, MA 01983 CERTIFICATE #:PEVD043156 CERTIFICATE #.

5 PEVD043156 Lexington INSURANCE Company44430 Robert V. Nuccio19437$1,000,000$1,000,000A4