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DATE(MMIDDlYYYY} <br /> ACC) CERTIFICATE OF LIABILITY INSURANCE ( 9/22/2016 <br /> THITCERTIFICATE 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 /> i 3ELOW. 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 /> CONTACT (''�C <br /> PRODUCER NAME: Elizabeth Holden <br /> Sentinel Risk Advisors, LLC PHONE <br /> fALC,NE.FYt)'919-388-1914 1(a/c.Ng):919-926-4664 <br /> . <br /> 4700 Six Forks Road <br /> Suite 200 E-MAIL <br /> ADDRESS:Iholden @sentinelra.com <br /> Raleigh NC 27609 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA:Arch Insurance Company 11150 <br /> INSURED <br /> NORT-29 INSURER B:ACCIDENT FUND INS CO 10166 <br /> North State Investment Group LLC INSURER C: <br /> Richard Hardin INSURER D: <br /> 1240 Corporation Pkwy INSURER E: <br /> Raleigh NC 27610 <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 1050186112 REVISION NUMBER: <br /> THIS IS TO INDICATED.CNOTWITHSTANDING ANY IREQUIREMENT,TERM OR CONDITION V OF ANY CONTRACT OR OTHER DOCUMENT WIDTH RESPECT PECT TO LWHICH TIHIS <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 /> INSR -ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM!DDIYYYY) <br /> A x COMMERCIAL GENERAL LIABILITY MAPK08365703 8/25/2016 8/25/2017 EACH OCCURRENCE $1,000,000 <br /> DAMAGE TO RENTED $100,000 <br /> CLAIMS-MADE ( X I OCCUR PREMISES(Ea occurrence) <br /> MED EXP(Any one person) _$5,000 <br /> X Professional Lia <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: - <br /> X POLICY 71N-j- — <br /> PRODUCTS-COMP/OP AGG $2,000,000 I ,LOC $ <br /> OTHER: COMBINED SINGLE LIMIT $ <br /> s 1 AUTOMOBILE LIABILITY MAPK08365703 8/25/2016 8/25/2017 (Ea accident 1,000,000 <br /> BODILY INJURY(Per person) $ <br /> ANY AUTO <br /> AUTOS NED © SCHEDULED BODILY INJURY(Per accident) $ <br /> NON-OWNED PROPERTY DAMAGE $ <br /> ident <br /> X HIRED AUTOS © Per acc <br /> AUTOS $ <br /> A X UMBRELLA LIAB X OCCUR MAUM08498003 8/25/2016 8/25/2017 EACH OCCURRENCE $4,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $4,000,000 <br /> DED RETENTION$ PER OTH- <br /> B WORKERS COMPENSATION WCV6095375-00 11/4/2015 11/4/2016 X I STATUTE ( ER <br /> AND EMPLOYERS'LIABILITY Y/N E.L.EACH ACCIDENT $500,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 <br /> (Mandatory in NH) <br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $500,000 <br /> DESCRIPTION OF OPERATIONS below , <br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County P.O.Box 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 200 S.Cameron Street ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> atii,44-c. a.i.v.„-A, <br /> 1 <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />