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DocuSign Envelope ID: 1582AE24-D793-4A66-9311-4472000BOEC3 <br /> ACCIIR CERTIFICATE OF LIABILITY INSURANCE 07122J2014 <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, EXTE140 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 MXDER. <br /> IMPORTANT- M the certificate Raider is an ADDITIONAL INSURED,the poiicylles)must be endorsed. If SUBROGATION 18 WAIVED,subject to the <br /> terms and Conditions of the policy, certain policies may require an endorsement. A statement on this:certificate does noit confer rights to the <br /> certiflCate holder In lieu of such andorsement(s), <br /> CONTACT <br /> Hanover Excess&Surplus, Inc. NAVAL <br /> PO Box 124.50 PHONE FAx Fjdj No); <br /> IUUI. <br /> WILMINGTON. NC.28405 *%M +PF vltcINOCOVERAGE . mtcs <br /> MsuaaItA. SCOTTSDALE INSURANCE COMPANY 41297 <br /> RISURM PERSONALIZED PATIEN'T'S HOME AS Il�IEREIta: <br /> tIISIEItl?R c:. <br /> 109 CONCORD DRIVE INSURER D; <br /> INS E: <br /> CHAPEL HILL, NC 27518 1 wowtot P. <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY T14AT THE POLICIES OF INSURANCE.LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> IN DICKTED. 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 /> FNBR TYPE OFINStMANCE P NUMBER POLICY EFf PCftICY1� L"Arm <br /> -AM GONERAL LL481LlFY EACH OCCURRENCE S 1,OOO,Q00 <br /> X COMMERCIAL GENERAL LIABILITY t-- S ao s 100,000. <br /> A CLAIMS-MADE K OCCUR k CPS20 3182 a�r22rzata oarz2r2o� <br /> nx�E"n' rev(anr me ) s 5,000 <br /> i PE MIAL"AM 1111URY 5 1,000,000 <br /> GENeRAL AGGREGATe s 2,000,000' <br /> GEN' AGiKGATEUMrrAPpLFESPER: PFtOOUCFS-C MP)oPAGG s 2,0001000 <br /> X POLICY Ll M LOC S <br /> A"OHOBN.E LIA®ltM - - IN O I f]MIT <br /> a den _ <br /> AMY AUTO BODA:Y WURY(Per persaq) S <br /> ALL OWNED SCHEDULED <br /> AUTOS -AUTOS BODILY OULAY(Par <br /> : 8.=. <br /> den1} s <br /> �U PRO ERTY. EW0. 4ALTO4 'AUTOS. I ........ <br /> i <br /> $H OCCUR <br /> �LWB � -EACH OCCURRENCE S <br /> rise Lust CLAIMS&WI! AGGREGATE <br /> Dw. RETET1TiON s <br /> WORKEAS*010431S.,AYMN - VMC STATU- OTH- <br /> AND EMP'LOYEAe'LAMAXTY -ANY PROPRIETOMPARTNERIEXECUTIYE YIN <br /> r E.L.EACH ACCIDENT s <br /> OFFK:ERR EXCLuDEOA 0 N I A! <br /> —INantl�ioq'irsI" - E.L.ONSME-EA EMPLOYE i <br /> MYem.daeoi6e under - <br /> E.L.OISEASE-POLICYLIMIT f <br /> F 17 Deductible-I -L <br /> DES"aF OPERATKIRB 1 LOCATIONS!V6ML9S(Abate ACORD 101.A&IN! d Ramrlla 9dw0u*,IT more apace is nqufred) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County DSS SHOULD ANY OF THE ABOVE DESCROW POLICIES BE CANCEL I Ffl BEFORE <br /> PO Box 8181 THE EMRATION DATE THEREW, NOTICE YVILL BE DEL VERED IN <br /> Hillsborough, NC 27278 ACCORDAxCE WITH THE POLICY PROVISIONS, <br /> AMOR2150 KPR—WirrAwa <br /> 0 1988-2070 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2410105) The ACORD name and logo are registered marks of ACORD <br />