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OP ID:MD <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(M 09/18/1 1a/1YYY) <br /> 3 <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 be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> High&Rubish Insurance Agency 919-913-1144 PHONE Fax <br /> P.O.Box 3040 919-913-1155 ac No Ext: A/c No): <br /> 6015 Farrington Rd.Ste 101 E-MAIL <br /> Chapel Hill,NC 27517 ADDRESS: <br /> Jeffrey A.Rubish PRODUCER HELPI-1 <br /> CUSTOMER ID i`: <br /> INSURER(S)AFFORDING COVERAGE NAIC k <br /> INSURED A Helping Hand INSURER A:The Travelers <br /> 1502 W Hwy 54 Ste 405 INSURER B:Cincinnati Insurance Companies 10677 <br /> Durham, NC 27707 INSURER C:U.S.Liability Insurance Co. <br /> INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 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 POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO RENTEU__ <br /> B X COMMERCIAL GENERAL LIABILITY HHC000588 03/01/13 03/01/14 PREMISES Ea occurrence $ 100,00 <br /> CLAIMS-MADE FX7 OCCUR MED EXP(Any one person) $ 10,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> POLICY PRO LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 <br /> (Ea accident) <br /> ANY AUTO <br /> BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS BODILY INJURY(Per accident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> B X HIRED AUTOS HHC000588 03/01/13 03/01/14 (Per accident) $ <br /> X NON-OWNED AUTOS <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y/N TORY IMITS 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 /> C D Liability ND01054177H 09/09/13 09/09/14 1,000,00 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANG-3 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange Count Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g Y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 South Cameron Street <br /> P.O. Box 8181 AUTHORIZED REPRESENTATIVE <br /> Hillsborough,NC 27278 L <br /> �-b <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD <br />