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ELCENTR-01 KLEE <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(M <br /> 7/23//201201YYY) <br /> 4 <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 pollcy(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 CONTACT <br /> NAME: <br /> IAS Associates,LLC PHONE 919 277-1330 Fax <br /> 5001 Weston Parkway Suite 105 A/C No Ell:( ) AIC No:(919)287-2995 <br /> Cary,NC 27513 EMAIL <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC N <br /> INSURER A:Philadelphia Indemnity Insurance Company <br /> INSURED INSURER B:Philadelphia Insurance Company <br /> El Centro Hispano,Inc. INSURER C: <br /> 600 East Main Street INSURER D: <br /> Durham,NC 27701 INSURER E: <br /> 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 POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MMIDD/YYYY MMIDD/YYYY LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> CLAIMS-MADE OCCUR PHPK1152648 04106/2014 0410612015 PREMISES Ea occurrence $ 100,00 <br /> ME EXP(Any one person) $ 5,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 <br /> X POLICY JECOT- F—] LOC PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> OTHER: ISexual Abuse $ 1,000,00 <br /> AUTOMOBILE LIABILITY Ea BIKED SINGLE LIMIT $ 1,000,00 <br /> A ANYAUTO PHPK1152648 0410612014 04/0612015 BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY Perarx )Jdent $ <br /> AUTOS AUTOS ( <br /> X HIRED AUTOS X NON-OWNED PROPERTY t DAMAGE $ <br /> AUTOS Per eooden <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 <br /> B EXCESS LIAB CLAIMS-MADE PHUB454223 0410612014 04106 12015 AGGREGATE $ 1,000,00 <br /> DED I X I RETENTION$ 10,000 $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICERIMEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ <br /> • Crime PHPK1152648 04/0612014 0410612015 Employee Dishonesty 120,00 <br /> • Professional Liabili PHPK1152648 0410612014 04106/2015 Each Claim 1,000,00 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached It more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 200 S Cameron St ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />