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DocuSign Envelope ID: 3F0F44D 1-0249-4 18D-A8C6-A7EDC76 1 CC87 <br /> AC®R®® DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 08/16/2017 <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(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> Marsh USA Inc. NAME: <br /> PHONE 701 Market Street,Suite 1100 (NC.No.Ext) (A/C,No): <br /> St.Louis,MO 63101 E-MAIL <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> ENTER-STNDX-GAW-16-17 3CL3 E-FM . INSURER A:The Travelers Indemnity Company of Connecticut 25682 <br /> INSURED INSURER B:Travelers Property Casualty Co.of America 25674 <br /> Enterprise Fleet Management,Inc. <br /> 600 Corporate Park Drive INSURER C: <br /> St.Louis,MO 63105 INSURER D: <br /> INSURER E <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CHI-008666858-01 REVISION NUMBER: 1 <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 TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY HC2E-GLSA-474M7351-TCT-16 09/01/2016 09/01/2017 EACH OCCURRENCE _ $ 3,000,000 <br /> DAMAGE TO RENED <br /> CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $ 1,000,000 <br /> X Fire Damage(Any One Fire) MED EXP(My one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 3,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 15,000,000 <br /> X POLICY PRO JECT LOC PRODUCTS-COMP/OP AGG $ 3,000,000 <br /> OTHER: _ $ <br /> A AUTOMOBILE LIABILITY HE-EAP-474M7302-TCT-16 09/01/2016 09/01/2017 COMBINED SINGLE LIMIT $ 3,000,000 <br /> (Ea accident) <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY (Per accident) <br /> X SIR 2,000,000 $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> B WORKERS COMPENSATION HRJ-UB-474M7062-16(WI) 09/01/2016 09/01/2017 X PER OTH- <br /> AND EMPLOYERS'LIABILITY -STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N HWXJ-UB-474M7074-16 (OH XS WC) 09/01/2016 09/01/2017 E.L.EACH ACCIDENT $ 1,000,000 <br /> B OFFICER/MEMBEREXCLUDEO? N N/A HC2J-UB-474M7050-16 (ALL 09/01/2016 09/01/2017 <br /> (Mandatory in NH) ( E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 'OTHER STATES)*SEE ATTACHED" 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Re:GPBR:3CL3;Address:4817 Hargrove Rd,Suite 109,Raleigh,NC 27616 <br /> Auto coverage insures any Auto owned or leased by the named insured while operated by employees of the named insured.No coverage provided to renters under this policy. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Attn:OrangeCounty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough,NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> of Marsh USA Inc. <br /> Manashi Mukherjee .nt.oL„taot.: <br /> ©1988-2016 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />