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DocuSign Envelope ID:OA6FEBA7-7CB5-4523-A4D2-2089COOE5340 <br /> DATE fMI11,'DD.-`Y"4'YY} <br /> CERTIFICATE OF LIABILITY INSURANCE 6/10/2015 <br /> THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED,subject to the <br /> 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 /> NAME. <br /> BB&T INSURANCE SERVICES INC/PHS <br /> PHONE (866) 467-8730 (NO ): (877) 538-5295 <br /> 272545 P : (866) 467-8130 F: (877) 538-5295 ADDRESS <br /> PO BOX 29611 INSURER(S)AFFORDING COVERAGE NAIL# <br /> CHARLOTTE NC 28229 iNSURERA Hartford Casualty Ins Co <br /> INSURED INSURER B <br /> INSURER C_ <br /> INFORMATION INC INSURER D: <br /> PO BOX 1306 INSURER E <br /> CARRBORO NC 27510 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 <br /> TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> I'VSR TYPE OF INSURANCE ADDL SCRR POLICT,N'L,IIRER POLICYEFF POLICFEXP LI,� <br /> 3L1I1D91YYYY <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 51, 000, 000 <br /> F <br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED s300, 000 <br /> PREMISES(Ea occurrence) <br /> A X General Liab 22 SEM 811951 11/30/2014 =1/30/2015 MED EXP(Any one person) .5101 000 <br /> PERSONAL&ADV INJURY 51, 0 0 0, 0 0 0 <br /> GEN'L AGGREGATE LIM IT APPLIES PER: <br /> GENERAL AGGREGATE s2, 000, 0 0 0 <br /> POLICY❑ PRO � LOC PRODUCTS-COMP AGG 52, 0 0 0, 000 <br /> JECT <br /> OTHER: s <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S1, 0 0 0, 000 <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> A ALL OWNED SCHEDULED 22 S3M RL19EI _1/30/2014 11%30/2015 BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE a <br /> AUTOS (Per accident) <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTIONS a <br /> WORKERS 40.M1IP6.N5.4 YIOA' PER OTH- <br /> AXDE.MPLUYERS'LIARILIrl` STATUTE ER <br /> ANY PROPRIETORIPARTNEWEXECUTIVE YIN E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? El WA <br /> (Mandatory In NH} E.L.DISEASE-EA EMPLOYEE a <br /> If yes.describe under a <br /> E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OFOPERARONS/LOCATIONS!VEHICLES(ACORD 901,Additional Remarks Schedule,may be attached if more space is required) <br /> Those usual to the Insured' s Operations. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County DSS AUTHORIZED REPRESENTATIVE r <br /> 113 MAYO STQ���,��� <br /> HILLSBOROUGH, NC 27278 <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD <br />