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l ® DATE(MWDD/YYYY) <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE <br /> 05/01/2018 <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 /> CONTACT <br /> PRODUCER NAME: Sam Muradyan <br /> Liberty United Insurance Services,Inc PHONE FAX <br /> (A/C.No.Ext): 8187618888 (A/C,No): 8882656889 <br /> 704 S Victory Blvd, Suite 204 E-MAIL <br /> Burbank, CA 91502 ADDRESS: Sam@libertyunitedinsurance.com <br /> License#: OF89841 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA: Admiral Insurance Company <br /> INSURED INSURER B <br /> MIMJA,Inc <br /> INSURER C: <br /> DBA Bouncyhouses.com <br /> PO Box 1108 INSURER D <br /> Snohomish,WA 98291 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 00000000-17041 REVISION NUMBER: 75 <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 ADDU SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) IMM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY CA000030534-01 04/28/2018 04/28/2019 EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 300,000 <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY I 1 PE T LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <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 /> A UMBRELLA LIAB X OCCUR GX000001305-01 04/28/2018 04/28/2019 EACH OCCURRENCE _ $ 1,000,000 <br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITYY/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? N/A <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 /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Insured's Copy ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> (SMS) <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> Printed by SMS on May 01,2018 at 02:01 PM <br />