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DocuSign Envelope ID:9D4EDDAF-2533-4423-9A3F-46FO3BDBE5BA <br /> DocuS!gn Envelope ID: 197749C3-FOCF-4B93-92EE-6391FF3B4743 <br /> ATE(MMIDWYYY) <br /> AC"RL> <br /> CERTIFICATE OF LIABILITY INSURANCE 11/30/15 <br /> F9 <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(ios)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 ilau of such endorserrient(s). <br /> PRODUCER CONTACT <br /> NAME: Ruth Carter <br /> — <br /> Thompson Insurance Enterprises LILC Ew: 678-290-2130 FAX <br /> 3380 Chastain Meadows Pkwy,Ste.100 DRESS:ARESS: rcarter@MarkelCorp,com <br /> Kennesaw,GA 30144 PRODUCER <br /> CUSTOMER 10 9; <br /> INSURER(S)AFFORDING COVERAGE NAIC or <br /> INSURED INSURER A: Essex Insurance Company . .. -- ----— 39020 <br /> Royall Harris INSURER B: National Union Fire Ins Co of Pittsburgh PA _J_q+j5 <br /> DBA:Character Antics INSURER C; <br /> 55 Twelve Oaks Lane INSURER O: <br /> Henderson,NC 27537 INSURER E <br /> I 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 19 SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ADOL SUBRI POLICY EFF POLICY EXP <br /> INSR TYPE OF INSURANCE POLICY NUMBER 1MM(DDfYYyy) (MMIDEVYYYY) LIMITS <br /> LTR INSR %WO <br /> CENERALLIABILITY EACHOCCURRENCE $—1000,000 <br /> -TJ­AfAU"OTrERTED- <br /> X CONIMIERCIALG NERALLIASILITY PRE,T MISES(Ea occonrents) $—1-00.1-0-00 <br /> r"1z;-1 4/17/15 4/17/16 <br /> CLAIMS-1.4ADE L_..__j OCCUR x FPG20011788-02 MED EXP(Ariy one person) $Excluded <br /> A PERSONAL&AOV INJURY S 1000000 <br /> GENERAL AGGREGATE s2,000,000 <br /> GEN1 AGGREGATE UPAITAPPLIES PER; PRODUCTS-COMPJOPAGG s2,000,000 <br /> n PRI n 15 <br /> -XI <br /> POLICY JEG1 LOC <br /> AUTOMOBILE LIABILITY Coh,4I31NED SINGLE LV,In` $ <br /> — (Ea aceldool) <br /> — ANY AUTO BODILY INJURY(Per persom) s <br /> ALILOVrNEO O SCHEDULED <br /> — AUTOS AUTOS HOULY INJURY(Per acc:denl) $ <br /> HIRED AUTOS NON-OWINED <br /> AUTOS PROPERTY DAMAGE $ <br /> H (Per accident) <br /> UMBRELLA LIAR OCCUR EACHOCCURRENCF $ <br /> EXCESSILKS CLAIMS-MADE AGGREGATE 15 <br /> DEE) RETENT! S <br /> VJORKERS CMIFENSAIION H. <br /> AND ENIPLOYERS'LIABIL" YIN R— <br /> ANY PROPRIETOWPARTNERIEXECUTIVE 0 E.L.EACH ACCIDENT $ <br /> OFFICEROAEMBER EXCLUDED? NIA <br /> (Mandatory In NI-1) E.L.DISEASE-EA EMPLOYEE It <br /> If es,describe under <br /> DESCRIPTION OF OPERATIONS Wow E.L.DISEASE-POLICY LIMIT $ <br /> 1 <br /> B Accident and Health SRG9111254-A-4360-00 4/17/15 4/17116 Plan C 4 15,000 I I <br /> DESCRIPTION CFOPERATIONS I LOCATIONS I VEHICLES(Attach ACORO iOl,Addillonal 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 /> H[Ilsborclugh,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS, <br /> AUTHORIZED REPRESENTATIVE <br /> @ 1988.2010 ACORD CORPORATION, All rights reserved. <br /> ACORD 25(2040106) The ACORD name and logo are registered marks of ACORD <br />