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DocuSign Envelope ID: C9602884-99B7-4D01-8E6D-E5DB069ABB26 <br /> CERTIFICATE OF LIABILITY INSURANCE RoRas 3721/2016' <br /> THIS CERTIFICATEIR ISSUED AS A MATTER OF INFORMATION ONLY AND rnNFFR-q NO RIGHTS I IPON E_GERTIFICATE 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 /> JOHNSON INSURANCE SERVICES INC/PHS (A/CO,N;Ex1): (AIAXC,No): (888) 443-6112 <br /> 272542 P: F: (888) 443-6112 ADDRESS: <br /> PO BOX 29611 INSURER(S)AFFORDING COVERAGE NAIL# <br /> CHARLOTTE NC 28229 INSURER A: Sentinel lns Co LTD <br /> INSURED <br /> INSURERS <br /> INSURER C <br /> CAROLINA SOFTWARE TECHNOLIGIES INC INSURER D: <br /> 1325 CENTRAL RD INSURER E: <br /> CLEMMONS NC 27012 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 TIPE OF INSURANCE ADDL SUBR POLICYNUMBER M/OLYEFF POLICYEXP LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> —1 Fx1 CLAIMS-MADE OCCUR PREMISES(Ea occu ante ) $1,000,000 <br /> A X General Liab 22 SBM ZG5326 06/25/2015 06/25/2016 MED EXP(Any one person) 10,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 OOO OOO <br /> POLICY�E T LOG PRODUCTS- s2,000,000 <br /> OTHER: $ <br /> COMBINED SINGLE LIMIT I <br /> AUTOMOBILE LIABILITY (Ea accident) $ ,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL A AUTOS OWNED FX AUTOS 22 22 SBM ZG5326 06/25/2015 06/25/2016 BODILY INJURY(Per accident) $ <br /> X HIRED AUTOS NON-OWNED PROPERTY DAMAGE <br /> AUTOS (Per accident) $ <br /> $ <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1,000,000 <br /> A EXCESS LIAB I CLAIMS-MADE 22 SBM ZG5326 06/25/2015 06/25/2016 AGGREGATE $1,000,000 <br /> DED X RETENTIONS 10,000 $ <br /> WORKERS COMPENSATION PER OTH- <br /> ANDEMPLOYERS'LIARILITY STATUTE JER <br /> ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> ❑ N/A <br /> (Mandatory in NH) E.L.DISEASE-FA 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 /> BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County AUTHORIZED REPRESENTATIVE ` <br /> PO BOX 8181 <br /> HILLSBOROUGH,NC 27278 <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD <br />