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DocuSign Envelope ID: 197749C3-FOCF-4893-92EE-6391 FF3B4743 <br /> DATE <br /> AC I I �I II� I 9/30/15(MMIDDYYY) <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,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 CONTACT <br /> NAME: Ruth Carter <br /> Thompson Insurance Enterprises LLC PA"IC°NN Exc: 678-290-2130 a/c-Ne_)___ <br /> 3380 Chastain Meadows Pkwy,Ste. 100 E-MAIL <br /> ADDRESS: rcarter @MarkelCorp,com <br /> Kennesaw,GA 30144 PRODUCER -- <br /> CUSTOMER ID#: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: Essex Insurance Company <br /> Royall Harris INSURER B: National Union Fire Ins Co of Pittsburgh PA <br /> DBA:Character Antics INSURER C <br /> 55 Twelve Oaks Lane <br /> INSURER D' <br /> Henderson,NC 27537 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 777491 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 TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ADcE SUER <br /> INSR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER M0IDDIYYYY MMIDDNYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> '..AMAUt X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 <br /> _ CLAIMS-MADE 1 OCCUR X FPG20011788-02 !I 4/17/15 4/17/16 MED EXP(Any one person) $ Excluded <br /> A PERSONAL&ADV INJURY $ 1,000,000 _ <br /> GENERAL AGGREGATE $2,000,000 <br /> '... <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $2,000,000 <br /> X POLICY D <br /> DECO-LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO - <br /> ALL OWNED ❑ SCHEDULED BODILY INJURY(Per person) <br /> AUTOS AUTOS BODILY INJURY(Per accident) $ <br /> HIRED AUTOS NON-OWNED ------ <br /> AUTOS PROPERTY DAMAGE $ <br /> (Per accident) <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LAB CLAIMS-MADE AGGREGATE $ <br /> DIED RETENTION$ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN CRY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> B Accident and Health SRG9111254-A-4360-00 4/17/15 4/17/16 Plan c $ 15 ,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 302 W Tryon Street, THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Hillsborough,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />