CERTIFICATE OF LIABILITY INSURANCE (6) M-
C It UA Alternative Balance LL
I1t 'd,flAN,C_ RM,P PO Box 538
Great American Alliance Insurance Company Mont Vernon, NH 03€57
301 E.Fourth Street,25 S 800-871-3848
Cincinnati„OH 45202-4201 contaeh AlternafiveB lance org
513-579.8304
COMMERCIAL GENERAL LIABILITY COVERAGE FORM—CLAIMS MADE COVERAGE
SPECIFIED FES I AL LIKABILITY COVERAGE FOR m-CLAIMS MADE COVERAGE
THIS POLICY IS WRH-TEN ON A CLAIMS MALE COVERAGE FORM
IT IS AGREED THAT THIS CERTIFICATE IS ISSUEf "Fo THE CERTIFICATE HOLDER LISTED BELOW TO CERTIFY COVERAGE
UNDER THE COMMERCIAL GENERAL LIABILITY INSURANCE MASTER POLICY LISTED BELOW
INSURANCE COMPANY: GREAT AMERICAN INSURANCE COMPANY
POLICY NUMBER:
NAMED INSURED. BEAUTY HEALTH&TRADE ALLIANCE PL-4959384
CERT"IFICAT"E HOLDER. Susan Rose, IBA Young at Heart CERTIFICATE NUMBER:
ADDRESS: 5014 S. Florida Ave#211, Tarpon Springs FL 34089
POLICY RERI I 01/28/2017 TO 01/28,2018 12:01 A I STt1NDArw TIME AT YOURADDflESS SHOWN.
,m
IN RETURN FOR PAYMENT OF THE PREMIUM,AND SUBJECT TO ALL OF THE TERMS OF THE POLICY,WE AGREE WITH YOU TO PROVIDE
THE INSURANCE AS STATEN IN THIS POLICY,
A. Specified Products, Goods, Operations and Premises Covered: Health and beauty related products and
goods normal and incidental to the practice of those Professional Services of which the Insured is a practitioner
or student practitioner, all related premises and operations of the Insr.tred
B. Professional Services; Massage and Related Modalities; Animal Massage and Related Modalities; Esthetics
Cosmetology, Fitness, Dance/Yoga Instructors and Mail Technician wort
,_- —._
LIMITS OF INSURANCE
General and Professional Aggregate Limit(Other than Products-
Completed Operations) 3.000.000'
Products- ornpleted Operations Aggregate Limit 3,000,000
Personal and Advertising Injury Limit INCLUDED
General and Professional Each Occurrence Limit 2.000.000
Damage to Premises Rented to You Limit 300,000 Any One Premises
Medical Expense Limit 31000 Any One Iverson
Identity Recovery Coverage Aggregate Lim It 15,000
LTeducfible 250
..._ _ _ __ �. _ _..m _
RETROACTIVE DATE:
RATE: FLAT
TOTAL POLICY COST: S
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Great American Alliance Insurance Company
301 L Fourth Street,25 S
C ncinnali,GI-f 45202-4201
511579-6300
THIS INSURANCE IS SUBJECT TO ALL THE TERMS AND CONDITIONS INCLUDING.APPLICABLE ENDORSEMENTS OF THE
COMMERCIAL GENERAL LIABILITY INSURANCE MASTER POLICY. A COPY OF THE COMMERCIAL,GENERAL LIABILITY
INSURANCE MASTER POLICY ACCOMPANIES THIS CERTIFICATE ADDITIONAL COPIES WILL BE PROVIDED TO THE
CERTIFICATE HOLDER IF REQUESTED BY THE CERTIFICATE HOLDER PLEASE READ THE POLICY AND ALL
ENDORSEMENTS.
NO ,ADMISSION OF LIABILITY MAY BE MADE EITHER VERBALLY IN WRITING
FULL DETAIL OF ANY INCIDENT SHOULD BE SENT IMMEDIATELY BY EMAIL TO CLAIMS@VERACITYINS CC)M OR BY LETTER
TO VERACITY INSURANCE SOLUTIONS, LLC 260 SOUTH 2500 WEST SUITE 303 PI...EASAN'T GROVE UT 84062
QUESTIONS:
Alternative Balance, LLC
PO Box 538
Mont Vernon, NH 03067
800-871-3848
ADMINISTRATOR'S SIGNATURE: e �'
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