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i <br /> AC DATE® DATE(MM1DDNYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 1/9/2014 <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(les)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 C NTACT Crystal Ireland <br /> N E: <br /> Business Insurers of the Carolinas PHONE (919)968-4611 FAX •(919)968-899Y. <br /> 800 •Eastowne Drive, Suite 208 Ao Ls.cireland @business-insurers.00m <br /> PO Box 2536 INSURERS AFFORDING COVERAGE NAIC 0 <br /> Chapel Hill NC 27515-2536 INSURERA.-Emeasco 21407 l <br /> INSURED INSURERB:EM to ers Mutual Casualt y 1415 <br /> DISPUTE SETTLEMENT CENTER INC INSURERC: <br /> 302 W WEAVER ST STE A INSURER 0. <br /> INSURER E: <br /> CARRBORO NC 27510-6004 1 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER-CL1353108570 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 ADDL POLICY EFF POLICY EXP LIMITS <br /> LT POLICY NUMBER MIDDIYYYY MWDDfYYyYI <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> X' COMMERCIAL GENERAL LIABILITY E occurrence) S 300 ,000 <br /> A CLAIMS-MADE aOCCUR 4w5,4487 /17/2013 /17/2014 MEDEXP(Any one person)_ $ 5,000 <br /> PERSONAL&AOV INJURY $ <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN-L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 2,000,000 <br /> X POLICY PRO- LOC $ <br /> AUTOMOSILELIABILITY E BIN SIN LIMI <br /> • <br /> ANY AUTO BODILY INJURY(Per person) $ _ <br /> AUTOS SCHEDULED BODILY INJURY(Per accident) $ . <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Pera i ent <br /> UMBRELLALIA6 H6CCUR EACH OCCURRENCE $ <br /> EXCESS LWB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTIONS $ <br /> B WORKERS COMPENSATION X WC STATU- 0TH- <br /> AND EMPLOYERS'LIABILITY FR <br /> ANY PROPRIETORIPARTNER/EXECUTIVE YIN E.L EACH ACCIDENT. S 100,000 <br /> OFFICERIMEMBER EXCLUDE07 NIA A54487 /17/2013 6/17/2014 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 100,000 <br /> 1iyea,describe under <br /> OESCRIPTiON OF OPERATIONS belay E.L.DISEASE-POLICY I IM IT $ 500 000 <br /> L _J DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,M more space Is required) - <br /> - <br /> CERTIFICATE HOLDER CANCELLATION- <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE. THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 S. Cameron Street <br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE <br /> C Ireland/IRELOI 49 <br /> ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> IN.S'A9.rirontMFlOt TAA At'.M011 Af`f1All <br />