Coast To Coast Tours Worker's Comp

                                    CERTIFICATE OF LIABILITY INSURANCE
                                                                                                                                                               DATE (MM/DD/YYYY)



  THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
  CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
  BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
  REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
  IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
  the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
  certificate holder in lieu of such endorsement(s).
PRODUCER                                                                                    CONTACT
                                                                                            NAME:
                                                                                            PHONE                                                FAX
                                                                                            (A/C, No, Ext):                                      (A/C, No):
                                                                                            E-MAIL
                                                                                            ADDRESS:
                                                                                            PRODUCER
                                                                                            CUSTOMER ID #:
                                                                                                              INSURER(S) AFFORDING COVERAGE                              NAIC #
INSURED                                                                                     INSURER A :

                                                                                            INSURER B :

                                                                                            INSURER C :

                                                                                            INSURER D :

                                                                                            INSURER E :

                                                                                            INSURER F :
COVERAGES                                   CERTIFICATE NUMBER:                                                                REVISION NUMBER:
  THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
  INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
  CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
  EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR                                             ADDL SUBR                                          POLICY EFF   POLICY EXP
 LTR             TYPE OF INSURANCE               INSR WVD               POLICY NUMBER              (MM/DD/YYYY) (MM/DD/YYYY)                          LIMITS
       GENERAL LIABILITY                                                                                                       EACH OCCURRENCE                $
                                                                                                                               DAMAGE TO RENTED
           COMMERCIAL GENERAL LIABILITY                                                                                        PREMISES (Ea occurrence)       $

               CLAIMS-MADE         OCCUR                                                                                       MED EXP (Any one person)       $
                                                                                                                               PERSONAL & ADV INJURY          $

                                                                                                                               GENERAL AGGREGATE              $

       GEN'L AGGREGATE LIMIT APPLIES PER:                                                                                      PRODUCTS - COMP/OP AGG         $
                      PRO-                                                                                                                                    $
           POLICY     JECT          LOC
       AUTOMOBILE LIABILITY                                                                                                    COMBINED SINGLE LIMIT
                                                                                                                                                              $
                                                                                                                               (Ea accident)
           ANY AUTO
                                                                                                                               BODILY INJURY (Per person)     $
           ALL OWNED AUTOS
                                                                                                                               BODILY INJURY (Per accident) $
           SCHEDULED AUTOS
                                                                                                                               PROPERTY DAMAGE
                                                                                                                                                              $
           HIRED AUTOS                                                                                                         (Per accident)

           NON-OWNED AUTOS                                                                                                                                    $

                                                                                                                                                              $
           UMBRELLA LIAB           OCCUR                                                                                       EACH OCCURRENCE                $
           EXCESS LIAB             CLAIMS-MADE                                                                                 AGGREGATE                      $

           DEDUCTIBLE                                                                                                                                         $

             RETENTION $                                                                                                                                      $
       WORKERS COMPENSATION                                                                                                         WC STATU-        OTH-
       AND EMPLOYERS' LIABILITY                                                                                                    TORY LIMITS        ER
                                        Y/N
       ANY PROPRIETOR/PARTNER/EXECUTIVE                                                                                        E.L. EACH ACCIDENT             $
       OFFICER/MEMBER EXCLUDED?             N/A
       (Mandatory in NH)                                                                                                       E.L. DISEASE - EA EMPLOYEE $
       If yes, describe under
       DESCRIPTION OF OPERATIONS below                                                                                         E.L. DISEASE - POLICY LIMIT    $




DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)




CERTIFICATE HOLDER                                                                          CANCELLATION

                                                                                              SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
                                                                                              THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
                                                                                              ACCORDANCE WITH THE POLICY PROVISIONS.


                                                                                            AUTHORIZED REPRESENTATIVE




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