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STARP-2 OP ID:PB1 <br /> ACORO° DATE(MWDDJYYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 10/22113 <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 Phone:910-455-7576 NAME: <br /> Triangle Insurance Group Inc Fax'910-455-7481 PHONE N ; <br /> 627 Gum Branch Road C <br /> Jacksonville,NC 28540 Res: <br /> Jim Nappier <br /> INSURE S AFFORDING COVERAGE NAIC tM <br /> INSURER A:Auto-Owners Insurance 16988 <br /> INSURED Starpoint,Inc. INSURER 8:FCCI Insurance 10176 <br /> PO Box 707 INSURER C:Accident Fund Ins.Co.of Amer <br /> Carrboro, NC 27510 <br /> INSURER D: <br /> f. INSURER E <br /> INSURER F: <br /> COVERAGES CERTIFICA'T'E 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 /> R <br /> ADM sum POLICY EFF TYPE OF INSURANCE POLICY NUMBER POL Y LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> DAMME To RENTED <br /> B rX COMMERCIAL GENERAL LIABILITY CPPOO13574 03125/13 03125114 PREMISES Es ce $ 100,00 <br /> CLAIMS-MADE Q!OCCUR MED EXP An one person) $ 5,00 <br /> PERSONAL 8 ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000.00 <br /> POLICY PRO LOC S <br /> AUTOMOBILE LIABILITY acciderd RGLE LSIACT.. . 1,000,00 <br /> A X ANY AUTO 936788500 02/26/13 02126114 BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Par accident) $ <br /> AUTOS AUTOS <br /> X' HIRED AUTOS X AUTOS WNED PPas'accktent E S <br /> $ <br /> UMBRELLA LIAB H OCCUR EACH OCCURRENCE S <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> QED I I RETENTIONS $ <br /> WORKERS COMPENSATION X WCSTATU- OTH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETORIPARTNERIEXECUTIVE YIN <br /> C NIA <br /> CV6090277 04112M 3 . 04/12/14 IEL,EACH ACCIDENT $ 1.000,00 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ 1,000.0 <br /> It yes,describe under 1,000,00( <br /> DESCRIPTION OF OPERATIONS hekrv� EL DISEASE-POLICY LIMIT S <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE? - <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County Health Dept. ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Janet Sparks,Keith Chnupa <br /> 131 West Margaret Lane AUTHORIZED REPRESENTATIVE <br /> Hillsborough,NC 27278 <br /> / ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD <br />