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DocuSign Envelope ID:64EBC657-51AC-4EF8-AD5C-3E50D999ACFF MDD DATE(MM/DD/YYYY) <br /> A`---'"R© CERTIFICATE OF LIABILITY INSURANCE 8054 1/22/2016 <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 Pao"ro,Ext): (866) 467-8730 (a,No): (888) 443-6112 <br /> 272545 P: (866) 467-8730 F: (888) 443-6112 ADDRIESS: <br /> PO BOX 29611 INSURER(S)AFFORDING COVERAGE NAIC# <br /> CHARLOTTE NC 28229 INSURERA: Sentinel Ins Co LTD 11000 <br /> INSURED <br /> INSURER B <br /> INSURER C: <br /> COMMUNITY EMPOWERMENT FUND INSURER D: <br /> 108 W ROSEMARY ST INSURER E: <br /> CHAPEL HILL NC 27516 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 /> INSR TYPE OF INSURANCE ADDL SURR POLICYNUMBER POLICYEFF POLICYEXP LIMITS <br /> LTR IN SR WUD MM/DD/YYYY MMDD YYY <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s2, 000, 0 0 0 <br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED 1 000, O O O <br /> _7 171 PREMISES(Ea occurrence) r <br /> A X General Liab 22 SBM BN9653 01/26/2016 01/26/2017 MED EXP(Any one person) $10, 000 <br /> PERSONAL&ADV INJURY s2, 000, 0 0 0 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s4, 000, 0 0 0 <br /> POLICY El ECT ❑X LOC PRODUCTS-COMP/OP AGG s4, 000, Q Q Q <br /> OTHER: <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 000 <br /> (Ea accident) s2, 000, <br /> ANY AUTO BODILY INJURY(Per person) <br /> AUTOS AUTOS <br /> A A O SCHEDULED 22 SBM BN9653 01/26/2016 01/26/2017 BODILY INJURY(Per accident) <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE <br /> AUTOS (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE <br /> DED I RETENTION$ <br /> WORKERS COMPENSA TION PER OTH- <br /> ANDEMPLOYERS'LIABILITy STATUTE I ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory in NH) ❑ E.L.DISEASE-EA EMPLOYEE <br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,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 /> Orange Count BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> g y DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO BOX 8181 AUTHORIZED REPRESENTATIVE <br /> 200 S CAMERON ST <br /> HILLSBOROUGH, NC 27278 / <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />