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ACCoR CID CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 12/23/2021 <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> Next First Insurance Agency,Inc. PHONE (855)222-5919 FAX <br /> PO BOX 60787 (A/C.No.Ext): (A/C,No): <br /> Palo Alto,CA 94306 ADR pp <br /> ADDDRESS: su ort nextinsurance.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A: State National Insurance Company,Inc. 12831 <br /> INSURED INSURER B: <br /> Cory Michaelis <br /> Cory Michaelis Comedy INSURER C: <br /> 525 E Beech St INSURER D: <br /> Everett,WA 98203 <br /> INSURER E <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER:5092710 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP <br /> D/ LIMITS <br /> LTR INSD WVD POLICY NUMBER (MMIDYYYYI (MMIDDIYYYYI <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000.00 <br /> DAMAGE RENED <br /> CLAIMS-MADE X OCCUR PREMISESO(Ea occurrence) $100,000.00 <br /> MED EXP(Any one person) $15,000.00 <br /> A NXTK9DHY43-00-GL 01/02/2022 01/02/2023 PERSONAL&ADVINJURY $1,000,000.00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000.00 <br /> _ <br /> X POLICY PROECT LOC PRODUCTS-COMP/OPAGG $2,000,000.00 <br /> J <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> _AUTOS ONLY AUTOS ONLY (Per accident) <br /> UMBRELLA LIAB _OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBEREXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Proof of Insurance. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Cory Michaelis <br /> Cory Michaelis Comedy SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 525 E Beech St THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Everett,WA 98203 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE _ <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />