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CERTIFICATE OF LIABILITY INSURANCE 07/22/2014W' <br /> A�a <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 the <br /> 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 /> Hanauer Excess&Surplus, Inc. _NAME__.__ <br /> PO Box 12450 PiuHOC"as: xt} <br /> E-MAIL <br /> WILMINGTON, NC 28405 ---�INSUREg US AFFORDING COVERAGE.. -- __- NAIC,# <br /> _._ ._____�—___�_ INSURER A:_SCOTT�SDALE INSURANCE.COMPANY 41297 <br /> INSURED PERSONALIZED PATIENTS HOME AS INSURER B: <br /> INSURER C <br /> 109 CONCORD DRIVE lNSURERD: <br /> INSURER E_--- __._. ---_ -- <br /> CHAPEL HILL, NC 27516 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`---__—ADDL SUBR ---` "— POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MMlDDJYYYY MMID YY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DA�tA(E T�R—ENDED 100 Q00 <br /> PREMISES LEa occurrence)__. $ — _._._.._..F7 F CPS2033182 07/22/204 o�122r2o1s — <br /> A _ �CLAIMS-MADE CX OCCUR - --� ME D EXP(Any one person),_____$ 5,000 <br /> PERSONAL&RDV INJURY $ 1,000,000 <br /> _GENE RALAGGREGATE $ 2,000,000 <br /> G_EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> X POLICY PRO• LOC $JE, COMBINED SINGLE i-IMIT <br /> AUTOMOBILE LIABILITY (Ea accident)___.-._—. <br /> -- i <br /> BODILY INJURY(Per parson) $ _ <br /> ANY AUTO _ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ — <br /> AUTOS AUTOS PROPERTY DAMAGE $ <br /> NON-OWNED ipar accident)_.—._-._.._._._—_... _._. <br /> HIRED At AUTOS $ <br /> UMBRELLA LIAR OCCUR F F EACH OCCURRENCE $ <br /> AGGREGATE _ <br /> EXCESS LIAR CLAIMS-MADE $ <br /> DED RETENTION$ WC STATU- OTH- <br /> _� WORKERS COMPENSATION TggY_LtMLLz <br /> AND EMPLOYERS'LIABILITY YIN E.L.EACH ACCIDENT --- <br /> ANY PROPRIETORtPARTNERtEXECUTIVE E L.DISEASE EA EMPLOYE_ $ <br /> OFFICEIMEMBER EXCLUDED? N 1 A — <br /> (Mandatory in NH) E.L.DISEASE-POLICY LIMIT c$c_ <br /> if yes,describe under nar1,rrtihle �j yQt----- <br /> �ft� ------- <br /> Schedule,if more space is required) <br /> DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks <br /> CANCELLATION <br /> CERTIFICATE HOLDER <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County DSS HE EXPIRATION ANCE DATE <br /> POLICY THEREOF, NTICE WILL BE DELIVERED IN <br /> PROVISIONS- <br /> PO Box 8181• NC 27278 <br /> }'-I11IS�7O{`�Ug AUTHORIZED REPRESENTATIVE <br /> ©1g 18-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />