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A CERTIFICATE OF LIABILITY INSURANCE ;ATE(M""10 M <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 eer0cate holder is an ADDITIONAL INSURED,the poiicy(iss)must be endorsed. if SUBROGATION 13 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 endorsem s. <br /> PRODUCER anjhcT Carla Dubuc <br /> Sanford Insurance Center P (919)775-7216 FAX (eseysla-iss7 <br /> 1722 S HORNER BLVD Kok <br /> INSURER(S)AFFORDRIG COVERAGE NAIC s <br /> SANFORD NC 27330 INSUMRA.Travelers Property Casualty 070 <br /> WSURED maumRs.L"'M Suret /Western Surety 039 <br /> Personalized Patients Home Assistance, DBA: INSURER C: <br /> 109 Concord Dr INSURER D <br /> f RE: <br /> lChapelHill NC 27516 RERF: <br /> COVERAGES CERTIFICATE NUMBER..CL1472502891 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 /> L TYPE OF MSURANCE POLICY N 12POW& MPOMM Lam <br /> GMERALLIABILITY EACH OCCURRENCE S <br /> DAWAGETOREIM <br /> COWERCIAL GE NERAI.LIABILITY $ <br /> CLAIMSAAADE E-1 OCCUR MED EXP one arson $ <br /> PERSONAL 6 AOV INJURY S <br /> GENERAL.AGGREGATE $ <br /> GENIA AGGREGATE L"T APPLIES PER PRODUCTS-COMPIOP AGO $ <br /> POLICY MM LOC s <br /> AUTOMOBILE LIABILITY L <br /> ANY AUTO BODILY NJURY(Per pwsm) S <br /> �� O� BODILY KMYPeacddat) $�0 AUTOS <br /> HIRD AUTOS p��ED $ <br /> S <br /> UMBRELLA LIAa OCCUR EA04 OCCURREMM S <br /> EXCESS Lu6 CLAIMSAAADE AGGREGATE s <br /> oN s <br /> A WOR10 Rs Cow"UTION x vNCS A . o - <br /> FR <br /> AND EMPLOYERV LIABILITY <br /> YIN <br /> ANY PROPRIETORIPARTNERAE(ECUTIVE EL EACH ACCIDENT S 100000 <br /> OFPICER/MEMBER EXCLUDED? � MIA <br /> (ManddayInNH) verage IDIC 20511160 /23/2014 (23/2015 E.L.DISEASE_EA EWLOYEE $ 100000 <br /> D PT°'�wN"�oPERATI NS below EL DISEASE-POLICY LIMIT S 500000 <br /> B Dishonesty Bond TM 06/18/2014 8/18/2015 sy,ppp <br /> i <br /> DESCRIPTION OF OPERATWNS I LOCATHM I VEMCLES Ueeoh ACORD 101,AddWonal Rwnarlw Schelde,It more opine Ia raqu"M <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 ass ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Boix 8181 <br /> Hillsborough, NC 27278 AUTtIORmEOREPREeENrATnrE <br /> S Insurance Co/CARLJL <br /> ACORD 25(2010105) 0 1985-2010 ACORD CORPORATION. All rights reserved. <br /> MlIM24 r"nmi m Thm sf"nDn rarer onrN I^nn*m ronWorwrl rnorke eel Arnr:n <br />