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ORANG-4 OP ID:AW <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) <br /> 01/2212014 <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 -High Point Phone:336-878-7800 NAME:CONTACT Anita Williams <br /> Senn 1400 Eastchester Drive,St 200 Fax:336-841-5319 HONE <br /> No,Ext:336-899-2402 FAX No):336-514-9414 <br /> High Point, 27265 ADMDRESS :awilliams@senndunn.com <br /> Small Business Accounts-HP <br /> INSURER(S)AFFORDING COVERAGE NAIC i <br /> INSURERA:Cincinnati Insurance CO. 10677 <br /> INSURED Orange County Disability Aware INSURER B: <br /> Dr.Tim Miles <br /> 503 W. Franklin St. Rm 113 INSURER C: <br /> Chapel Hill, NC 27514 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 MAYHAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR <br /> LTR TYPE OF INSURANCE INSR D POLICY NUMBER MMIDD�Y MMIDDIYYYY LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE $ 1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY EN 0128897 02/28/2014 02/28/2015 AMAGETO R <br /> PREMISES Ea occurrence $ 500,00 <br /> CLAIMS-MADE FX_1 OCCUR MED EXP(Any one person) $ 10,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> POLICY PRO- 7 LOC JEmp Bene $ 1,000,00 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000000 <br /> Ea accident $ , <br /> A ANY AUTO ENP 0128897 02/2812014 02/28/2015 BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY(Per accident) $ <br /> X NON-OWNED PROPERTY DAMAGE <br /> X HIRED AUTOS <br /> AUTOS Per.cadent $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION __WO C STATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN Y IMITS FR <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E L EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED? � NIA $ <br /> (Mandatory in NH) E1 DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below F1 DISEASE-POLICY LIMIT Is <br /> F1 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> PROOF <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> PROOF OF COVERAGE ONLY ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED <br /> �/ � <br /> REPRESENTATIVE <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />