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EMPOW-1 OP ID:LR <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(AA3120 <br /> M0712312014 <br /> 4 <br /> 1a <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 N00NTEACT Michael Rig bee,Jr. Luke <br /> Carolina National Ins Agncy <br /> 1526 E.Franklin St.Suite 102 A°"0 Em:919-636-3252 riatc N,:919-890-0246 <br /> Chapel Hill,NC 27514 E-MAIL <br /> Michael Riggsbee,Jr. ADDRESS:luke@cniagency.com <br /> INSURER{S)AFFORDII G COVERAGE NAIC <br /> INSURER A:AmTrust North America <br /> INSURED Empowerment,Inc. INSURERS: <br /> 109 N.Graham St.#200 <br /> Chapel Hitt,NC 27516-2328 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 I SUBIR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER M IDD LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> CLAIMS MADE a OCCUR X NPP1005089 06!1612014 06/16/2015 PREMISES Ea occurrence $ INC <br /> MED EXP(Any one person) $ 10,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,00 <br /> POLICY J RCO F LOC PRODUCTS-COMPtOP AGG $ INC <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 <br /> (ga accident)A ANY AUTO NPP1005089 06116/2014 06116/2015 BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY(Per accident) $ <br /> X HIRED AUTOS X NON-OWNED PROPER DAMAGE $ <br /> AUTOS Per accident <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION X PER OTH <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> A ANY PROPRIETORIPARTNERIEXECUTNE <br /> YIN TWC3423896 06/16/2014 06/16/2015 E.L.EACH ACCIDENT $ 500,00 <br /> OFFICERIMEMBER EXCLUDED? El NIA <br /> (Mandatory in NMI E.L.DISEASE-EA EMPLOYE $ 500,00 <br /> 11 yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,00 <br /> A Professional Liab NPP1005089 06/1612014 06/16/2015 Occurrenc 1,000,00 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached 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 /> Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE <br /> Michael Riggsbee,Jr. <br /> 0198&2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />