2016-492-E Aging - Flaircare dba Homewatch CareGivers for in-home services

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DocuSign Envelope ID: C33B4E4E-6357-44A2-8A64-68B007E0F277 FLAIR-2 OP ID: LR .4 CC)i? CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `••-- 08/16/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Margo G. Roberts,AAI,CISR Summers Thompson Lowry,Inc. PHONE FAX 100 Europa Drive,Suite 571 (A/C,No,Ext):919-969-5300 (A/C,No): 919-942-4221 Chapel Hill,NC 27517 E-MAIL g ADDRESS:mar o stlinsure.com Larry A.Summers INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:GMAC/National General INSURED Flaircare, Inc DBA INSURERB:ACE USA(inland marine) Homewatch Caregivers 101 Cosgrove Ave,Ste 120 INSURER C: Chapel HIII, NC 27514 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR TYPE OF INSURANCE I POLICY EFF POLICY EXP INSR WVD POLICY NUMBER /Y LIMITS (MM/DD YYY) (MM/DD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 B X COMMERCIAL GENERAL LIABILITY MLP G27939594 001 01/01/2016 01/01/2017 DAMAGE TO RENTED 300 000 PREMISES(Ea occurrence) $ X CLAIMS-MADE OCCUR MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 POLICY PRO- JECT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 000 000 (Ea accident) $ s s A ANY AUTO 2002648393 04/18/2016 04/18/2017 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS APER ACCIDENT) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Professional Liab MLP G27939594 001 01/01/2016 01/01/2017 Each 1,000,000 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Abuse and Molestation $1,000,000 per claim and $1,000,000 aggregate For Information Purposes CERTIFICATE HOLDER CANCELLATION HOMEWAT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Homewatch CareGivers of the ACCORDANCE WITH THE POLICY PROVISIONS. Triangle 1210 SE Maynard Rd.,Ste 202 AUTHORIZED REPRESENTATIVE Cary, NC 27511 Larry A.Summers ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD