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DocuSign Envelope ID: 7DA537F6-EEE6-4EEA-B8F6-9B994A704826 THE HARPER AGENCY PAGE 02102 <br /> NICEAND-01 JNEWtON <br /> CERTIFICATE OF LIABILITY INSURANCE Dane(7rmFjmDN�MIDDrYVrY) <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAfJON 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 certlflcata holder Is an ADDITIONAL INSUKED,the policy(ie5)must be endorsed, If SUBROGATION IS WAIVED,subject to <br /> the terms and conditlorm of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in liou of such endoroement(s). <br /> PRODUCER ROME: Jennifer S. Newton <br /> The Harper Ageneyr,Lester Insurance Group Inc. P110N n Ex (3S6)227P71 w <br /> PO Sax 1$ G No <br /> 67 P.M <br /> 1097 S.Main Street <br /> ADDRESS: <br /> Burlington,NC 27216 <br /> INSURER(g)AFFORDING COVERAGE NAIL H <br /> INSURERA:Erie Insurance Exchange 2827'1 <br /> INSURFd7 INSURER B <br /> Nice✓&Green FlDaring Solutions,LLC INSURER c: <br /> 1183 University Drive 9105-113 INSURER D: <br /> Burlington,NC 27215 INSURER E' <br /> INSURER F: i <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE SEEN 13SOED TO THE INSURED NAMEDABOVE FOR.THL 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 6EEN REDUCED BY PAID CLAIMS, <br /> INSR TYPE OFINSURANGE 1N yayp POLICYNUMSER POLICY Y MNIO LIMITS <br /> A x COMM FRCIALGENERALLIABILITY EAGHOCCURRENCE g 1,006,000 <br /> CLAIMS-MADE 0 OCCUR 03M750784 OS167l2015 0310712016 PREKSE3 Eaaccurante $ 1,000,000 <br /> MED EXP(Any one peraon) 1 5,000 <br /> PERSONAL S ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGRSDATE $ 2,000,000 <br /> JE <br /> POLICY F] GPRO T LOG PRODUCTS-CQMPKSPQGG $ 7r600r00 <br /> x <br /> OTHER; <br /> 3 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea acddan <br /> ANY AUTO BODILY INJURY(Perperaan) $ <br /> ALL OWNED SCHEpUI.ivD BODILYINJURY(P-=nc derl) $ <br /> AUTOS Auras $ <br /> HIRED AUTOS NON-OWNED PP OPERTY DAMAGE <br /> Auras ( r maidgnt) <br /> $ <br /> DMBRELLAt" OCCUR EACH OCCURRI=NCE # <br /> P=1120 LIAR GOIMS-MADE! AGGREGATE $ <br /> DED RETENTIONS <br /> WORKUR.SCOMPENSATION PTR T ERH <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETORIPARTN-zA"rCUT!VE Y� N IA E.L.EACH ACCIDENT $ <br /> CFFICERNEMBER FXQLUDQD7 <br /> (Mandatary in Nlr) S.L.DISEASE-EA EMPLOYEE S <br /> li yga# deacdtae urdar <br /> DESCit1PTION OF OPERATIONS bbkw EL.OISEASE-POLICY LIMIT 6 <br /> DESCRIPTION OF OPERATIONS J LOCATIONS I VEHICLES (ACORD 101,Addi lonal Ramaria Schad,da,mxy ha attachea tt mori spwo IS requirso) <br /> i <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABQYI DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Social Services THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELFUERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS, <br /> 113 Mayo St. <br /> Hillsbarough,NO 27278 <br /> AUTHDRIiED REPRESENTATIVE <br /> �D 1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014161) The ACORD name and logo are registered marks of ACORD <br />