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DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF <br /> First <br /> ,.Y . . . <br /> Eft <br /> klsurance Cmp(yrly <br /> I South Wacker Drive, Suite 238,0: <br /> Chicago, IL 60606 <br /> 312-715-3010 <br /> MULTIPLE PERIL POLICY <br /> DECLARATIONS <br /> f7oliGy Number:,Ni'P1006082 00 Producer:Insurance,service Canter of F ayettevilla, <br /> Named Insured: Bethesda Care LLC,: <br /> Keston Care <br /> M601ing Addrm 1:1:312 Hwy 15.501 Norlb <br /> Obatham Crossing.Ste 400 <br /> Chapel.Hill NC 27514 <br /> Term of CoverW. Frarrt 10/5/2014 To 10/612015 12:01'a.m.Loral Tilte at,Your <br /> Mailin Address,Si own Above <br /> Rost Anrtu'2'd Premium: �1 <br /> Cwnragee Provided <br /> In return for your payment of the f"uir0d.Pfsmlum,we provide the covera;tge.described irr"tht PoIIGy*" <br /> Section In <br /> A. General Conditions <br /> Property lnsuranc43,yes <br /> 8.. Terms&Conditions—All Propeny`and ReWed Coverages . <br /> Option Coverages , <br /> C. General Property <br /> D, income Protection&a~)dra Expense <br /> E. Sect Pera4nal PrOp" <br /> F.. Garrtpu4ers ® :El G. Grime <br /> Prirrrary l_iaVd1ty lrlUrances <br /> H. Terms 8r<Conditions—.Primary i_iability Coverages <br /> �, t�pticu181 Ccrve�ageffi <br /> 1 $0011y fniury and Property Dacnsge 1 iability � I <br /> J1 Sexual Abuse Liat lhty <br /> K. Social Work.:FosWCare and Counseling Liability 0 13 <br /> 4_ Mcaf Lability <br /> .M. Personal and Advertising Injury,Liability � <br /> N. Non-Owned and:Ffired i to Liability . <br /> C. Medical Payments <br /> P. Employee Benefits Administration Liability E3 Is <br /> Additional fonds applicable to this policy: <br /> Cate: 1 DM014 by: <br /> W <br /> - <br /> First Rona`ofit In su1 eh' GA ! ', <br /> Authorized.Rapressni�ve <br /> :-� 0412f!O PKG 1000 Page 1 bf"5 <br />