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CHARL-1 OP ID:LR <br /> CERTIFICATE OF LIABILITY INSURANCE <br /> DATE 4 <br /> 14 <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 <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 /> Carolina National Ins Agncy NAME: Michael W Riggsbee,Jr <br /> 1526 E.Franklin St.Suite 102 aCNr o Ell: FAAf�No):919-890-0246 <br /> Chapel Hill,NC 27514 EpMA Lss:Luke cniagency.com <br /> Michael Riggsbee,Jr. <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Philadelphia Insurance Company 18058 <br /> INSURED Charles House Association INSURER B:iSurity,Inc. <br /> 109 Hillcrest Avenue <br /> Carrboro,NC 27510 INSURER C: <br /> INSURER D: <br /> 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 DL POLICY NUMBER MM/DD/YYYY MM/DDIYYY <br /> LTR Y LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE _$ 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY PHPK1008025 0511012014 0511012015 pREMtSES Ea occurrence $ 100=00 <br /> CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 5,00 <br /> PERSONAL&ADV INJURY $ 1:000,00 <br /> GENERAL AGGREGATE $ 3,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 3,000,00 <br /> POLICY PRO LOC g <br /> JECT 1-1 AUTOMOBILE LIABILITY CO BINED INGLE LIMIT 1,000,00 <br /> Ea accident $ <br /> A ANY AUTO PHPK1008025 05/1012014 05110/2015 BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> HIRED SAUTOS Ix NON OWNED PROPERTY DAMAGE $ <br /> AUTOS PER ACCIDENT <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LtAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION WO STATU- OTH- <br /> AND EMPLOYERS'LIABILITY X TORY IT <br /> ER <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE YI N C19056-2013 06125/2014 06125/2015 E.L.EACH ACCIDENT $ 500,00 <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,00 <br /> if yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 <br /> A Professional Lia PHPK1008025 05/10/2014 05/10/2015 Ea Inci 1,000,00 <br /> Aggregate 3,000,04 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <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 /> For Information Only*`* ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> Michael Riggsbee,Jr. <br /> CU 1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />