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13INSURANCE TI I TI - XIBITZ <br />A IC :ERTIFICAT OF LIABILITY INSURANCE NCE DATEtMWDDnYYYI <br />�„�, UI2812017 <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 pollcy(les) 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 ri hts to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />C""ACT.... Angie Fagan <br />Olivier-VanDyk Insurance Agency <br />2780 44th Street SW <br />Wyoming MI49519' <br />PHONE FAX <br />. 616-454-0800 Aix Nor 616-454-7100 <br />E-MAIL .angIo@ovdinsurance.cnm <br />INSURER(S) AFFORDING COVERAGE.. <br />NAILA <br />INSURER A:Cincimati Insurance Compaq <br />10677 <br />INSURED XIBIINC-01 <br />INSURER IT Accident Fund Company <br />10166 <br />Xihitz, Inc. <br />5809 Cross Roads Parkway SW <br />Grand Rapids MI 49519 <br />NISUREHD: <br />INSURERS: <br />INflUHER E : <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 680139776 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 REOUiREMENT„ 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 />INSH <br />'.... Um <br />TYPEOFINBURANCE <br />AUUL.. <br />INSD <br />WVD <br />POLICY Nomura <br />POLICY EFF <br />rAMA?OMYYy) <br />PO 0 EXIP <br />1MMA1DNyYY) <br />Limit$ <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EPP0821258 <br />31150017 <br />3/15/20IB <br />(EACH OCCURHENCE <br />$t 000 DOD <br />CLAIMS -MADE OCCUR <br />DAMAGSEaom"TT TO <br />$I00,00D <br />ME 1) EXP(An — pemomf <br />$5000 <br />PERSONAL &ADV INJURY <br />$11000,000 <br />GEHL <br />AGGREGATE LIMIT APPLIES PER:'. <br />GENERAL AGGREGATE: <br />$2,000.000 <br />POLICY [ J CT LOC <br />PRODUCTS-COMPR)PAGO <br />$2000001) <br />$ <br />OTHER.: <br />A <br />AUTOMOBILE <br />LIABILIT1/..... <br />EPPOS27250 <br />30512017 <br />3/15/2018 <br />Ea acdrf <br />611000,000 <br />% <br />ANY AUTO <br />BODILYINJURY (Pen person) <br />$ <br />* <br />OWNED SCHEDULED <br />AUTOS ONLY I AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY X AUTOB ONLY <br />BODILY INJURY (Pei aaciden0 <br />$ <br />Per acddent <br />$ <br />$ <br />A <br />X <br />DOCUR <br />E'PP0827258 <br />3Jf5Md017 <br />3/15/20I8 <br />EACH OCCUR'RENOE <br />$1O,OW,000 <br />AGGREGATE <br />$10,000,000 <br />jX,,,MB1,,1,,,LLAUABU <br />CEIAif <br />CLAIMS -MADE <br />ED X RETIENTION$O <br />B. <br />WORKERS COMPENSATION <br />AND EMPLOYERS" LIABILITY YIN <br />ANY PROPRIETORPARTNERIEXECUTNE <br />OEEtCEIuMEMBER EXCLUDED? <br />N/A <br />WC'V6141087-0 <br />3P1'.5=7 <br />3/15/20/13 <br />X I gTATUTE I I OR <br />E.L EACH ACCIDENT <br />$1,000,000 <br />E.L DIISEASE- EA EMPLOYE <br />$1000,000 <br />(Mandatary In NH) <br />IF ryeaa dCP: ribs andEf <br />OEB'I�RIPTIONOF OPERARoNSbilDW <br />E.L DISEASE -POUCY LIMIT <br />$1'.,000,W0 <br />A <br />ErnDrs B+Ornmisslons <br />EPP082725B <br />3/15f2017 <br />3/15/20L8 <br />Limit 1,011,000 <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORO 101, Additional RemnrkaSchedule, maybe allnched it more apace Is required) <br />SHOULD ANY OF THE ABOVE. DESCRIBED POLICIES BE CANCELLED BEFORE <br />"" .FOR INFOHMIATIONAL PURPOSES ONLY— THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IIN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />ACORD 26 (2016/03) <br />The ACORD name and logo are registered marks of ACORD <br />4�, , �tl Nf EXPERIENCES 48 <br />C1 „raLA i'U /1'+I !i i II! , a BUILT <br />