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? <br />w <br />ALLIED SPECIALTY INSURAMCEt INC. <br />14451 GULF HLVLi. # TF:EASUFE ISLANL, FLOF:ILA 33706 <br />ToLI Free 1-804-237-3355 National <br />1-800-282-6776 FLorida <br />F'olicy No: 9LM22961 Certificate IVo. 78 <br />CEFTIFICATE OF INSURANCE <br />This i5 to cel'tify that poLiciea in the name ofE MAYFIELD VILLAGE <br />Named ? American Fireworks Co< IAdditionall MAYFIELD VILLAGE RACQUET ? <br />Insured P.O. Hox 394 Insured CLUB <br />And Hudaon. OH 44236 <br />Address . <br />are in force at the date hei-eofi, as foLLows2 <br />R-in-d---of --I-n--su-----rance ----- P oL--ic umb-Y-N----e-r-s ---- F•-o---L i c-y-?'---er-i--od -------- L--im --i t-s ------ <br />--------------------------------------------------------------------- <br />FIFEWORY:S DISPLAY 9LM22961 Eff: 04-02-89 51j,000j,000 CSLw <br />LIARILITY INSURANCE Exp: 04-02-90 <br />COMPANY i <br />T.H.E. Insui-ance <br />Gompany <br />EXCESS FIREWOkICS I I Eff f <br />DISF'LAY LIAbII.ITY ? Exp 2 <br />Ii?SURANCE COMFA?lYS ? <br />COMF'ANY 2 ? I Ef f: <br />Exp2 <br />*CSL - CQMBINEL BINGLE LIMIT <br />In the event of any materiaL change in, or canceLLatian of said <br />Wiciess the undersiqned will endeavor to give written no?ice to <br />party to whom this certificate is issued, but failui-e to give <br />such notice shaLt impose no obLigation or LiabiLity upon the company. <br />CERTIrICATE ISSUED T0: MAYFIELD VILIIArE UATE OF DISRLAY AUGUST 13, 1989 <br />NAME pgt, FRED N. CARMEN <br />AND 6621 Wilson Mills Road RAIN DATE August 18, 1989 <br />AL?DRESS <br />Mayfield Village, Ohio DISFLAY AFfOUNT <br />44143 LOCATION OF IIISFLAY 6685 Beta Drive <br />This certificate neither afPirmativeLY nor negativeLy amends extends <br />or alters the coverage afforded by any poLicy described herein. <br />NOTES In event rain or inclement weather prohibits this displaY, <br />coverage will apply ona subsequent date on which display is held, <br />within the tei-ms of thia contract. CLeanup and policing of the <br />displaY are the respansibfL itv nf the Sponsors. <br />The foLlowing are additlonal insui-eds; AnY fair oi- exposition, <br />association, sponsoring organization or committee, the owner nr <br />Lessee of any premisee uaed by the named assured, or any public <br />authoritY granting a permit to the named assured, but onLy as <br />respects accidents arising outof the business operations of the <br />pi-imary assured. ALso, as additionaL named insured any independent, <br />conti-actoi- who fires the dispLay on behaLf of the assured. <br />This certificate is not vaLid unle,s? an or'gina sie ture appears <br />below (copies are not vaLid). <br />PldL'Gh_7?Q?g 14$Q4Yh--- gnatul-e <br />ate or ertificate 3ssuance Aut?i ize ?