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ACORN® CERTIFICATE OF LIABILITY INSURANCE DATEMM/DD/YYYY) <br /> 1131/2(014 <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 INSiJRER(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 Co T CT <br /> NAME: <br /> SilverStone Group PHONE a c No:C.11516 Miracle Hills Drive E-MAIL - " <br /> Suite 100 ADDRESS: <br /> Omaha NE 68154 INSURERS AFFORDING COVERAGE NAIC N <br /> INSURER A:Ph*ladelphoa Insurance Company 2A850 <br /> INSURED 14508 INSURER B: <br /> KAH Care LLC INSURER C: <br /> Right at Home INSURER D: <br /> 9417 Collingdale Way <br /> Raleigh NC 27617 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:174287232 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 F:ESPECT 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 /> I�TR R TYPE OF INSURANCE IN SR WV POLICY NUMBER MM DDY/YYYY MM/DDIYYYY LIMITS <br /> A GENERAL LIABILITY PHPK1128743 /16/2014 /16/2015 EACH OCCURRENCE $1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES E o n i $1,000,000 <br /> CLAIMS-MADE a OCCUR MED EXP(Anyone pan on) $20,000 <br /> PERSONAL 8 ADV INJI IRY $1,000,000 <br /> GENERAL AGGREGATE $.3,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OI'AGG $3,000,000 <br /> X POLICY PRO- LOC $ <br /> A AUTOMOBILE LIABILITY PHPK1128743 /16/2014 /16/2015 Ea accident) $1,000,000 <br /> ANY AUTO BODILY INJURY(Per parson) $ <br /> ALL OWNED <br /> AUTOSI AUTOESULED BODILY INJURY(Per a(cident) $ <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS Per acciden <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ r $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN <br /> ANY PROPRIETOR/PARTNERIEXECUTIVE E.L EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory In NH) E.L.DISEASE-EA EMF LOYE $ <br /> B yes,desuibe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Crime 3HPK1 128743 16/2014 1612015 Limit 25,000 <br /> Professional Liability Limit 1M/3M <br /> Property Limit 20,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIE: BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Right at Home ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 6464 Center Street Suite 150 <br /> Omaha NE 68106 AUTHORIZED REPRESENTATIVE <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />