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DocuSign Envelope ID: DB61356E-7ACB-4248-A6B4-08C4BC04350D <br /> Client#:1384868 20EXCHACLU <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE FW.TE(MM/DDNYYY) <br /> 07/08/2015 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHT'S 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 NAMEAOT Patty Degina <br /> BB&T Insurance Services, Inc. arc°No E�r:919 281-4525 AX 888746$761 <br /> Post Office Box 13941 E-MAIL Arc No <br /> Durham, NC 27709 ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> 919 281 4500 INSURER A:Accident Fund Ins Co of America 10166 <br /> INSURED INSURER B <br /> Exchange Club Center for the Prevention <br /> of Child Abuse INSURER C <br /> 500 W Northwest Blvd INSURER D: <br /> Winston Salem, NC 27105 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 CONTRACTOR 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 /> INSR ADOLSU13R POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE IN WVD POLICY NUMBER MMIDD MMIDD LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAM AS RENTED <br /> PAEMI 5 Ea occurrence $ <br /> CLAIMS-MADE El OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENEAALAGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICY Pr C' LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY(Per accident) $ <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE <br /> AUTOS PeraccidenF $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE <br /> AGGREGATE $ <br /> DED RETENTIONS $ <br /> A WORKERS COMPENSATION <br /> AND 1/27/2015 01/27/201 )( WCSTATU- OTH- <br /> ANDEMPLOYERS'LIABILITY YIN <br /> ANY PROPRIETORIPARTNERIEXECUTIVE £.L EACH ACCIDENT $100,000 <br /> OFFICERIMEMBER EXCLUDED? NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,()00 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> P.O. BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough, INC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> O <br /> 11588-2010 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S14464971/M13776615 PD4 <br />