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DocuSign Envelope ID:CDCEC775-C81E-44AD-AB72-5C4ADF26C195 <br /> CERTIFICATE OF INSURANCE ISSUE DATE <br /> c o November 21,2017 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS <br /> UPON THEIR CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER <br /> THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> The Snowden Company <br /> PO Box 5319 COM PANI ESAFFORDING COVERAGE <br /> Fl orence, South Carolina 29502-5319 <br /> COMPANY A ACE Medical Risk <br /> LETTER <br /> Ace American I nsurance Company <br /> INSURED COMPANY B <br /> LETTER <br /> ORANGE COUNTY HEALTH DEPARTM ENT COMPANY C <br /> SUSAN WARD LETTER <br /> 300 W.TRYON STREET COMPANY D <br /> HI LLSBOROUGH, NC 27278 LETTER <br /> COMPANY E <br /> LETTER <br /> COVERAGES <br /> THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR <br /> THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR <br /> OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE <br /> AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH <br /> POLICIES. <br /> CO TYPE OF INSURANCE POLICY NUMBER FOLICYEFFECTIVE POLICY EXPIRATION ALL LIMITS IN THOUSANDS <br /> LTR DATE MM/DD/YY DATE MM/DD/YY <br /> GENERAL LIABILITY GENERAL AGGREGATE <br /> - COMMERCIAL GENERAL LIABILITY PRODUCTS-COM P/OPS AGGREGATE _ <br /> -- CLAI MS MADE OCCURRENCE PERSONAL&ADVERTIS NG INJURY _ <br /> - OWNER'S&CONTRACTORS PROTECTIVE EACH OCCURENCE _ <br /> - FIRE DAMAGE(ANY ONE FIRE) _ <br /> - MEDICAL EXPENSE(ANY ONE PERSON) _ <br /> AUTOMOBILE LIABILITY CSL <br /> - ANY AUTO <br /> ■ ALL OWNED AUTOS BODILY <br /> INJURY <br /> - SCHEDULED AUTOS (PER PERSON) $ <br /> ■ HIRED AUTOS BODILY <br /> INJURY <br /> ■ NON-OWNED AUTOS (PER $ <br /> ACCI DENT) <br /> ■ GARAGE LIABILITY PROPERTY <br /> DAMAGE <br /> - $ <br /> EXCESSLIABILITY EACH AGGRE <br /> OCCURRENCE GATE <br /> - $ $ <br /> - OTHER THAN UMBRELLA FORM <br /> STATUTORY <br /> WORKERS COMPENSATION I $ (EACH ACCI DENT) <br /> AND $ (DISEASE-POLICY LIMIT) <br /> EMPLOYERS LIABILITY $ (DISEASE-EACH EMPLOYEE) <br /> A OTHER MLPG21686038-15 11/22/2017 7/1/18 LIMITS: $1,000,000 Each CIaim <br /> Professional liability $3,000,000 Aggregate <br /> DESCRI PTI ON OF OPERAT I ON S/L OCATI ONS/V EH I CL ES/RESTRI CT I ONS/SPECI AL ITEMS: Dorothy Cilenti and Health <br /> Ascent Associates, L LC is provided professional I i abi I i ty coverage within the scope of contract services provided to the Orange County <br /> Health Dziartment. Retro Date: 11/22/2017 <br /> CERTIFICATE HOLDER CANCELLATION <br /> Ms. Dorothy Cilienti SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE <br /> y EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> Health Ascents Associates LLC 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO 238 Trout Lily Lane KIND UPON THE COMPANY,ITS AGENTS ORREPRESENTATIVES <br /> OR LIABILITY OF ANY <br /> Pittsboro, NC 27312 <br /> AUTHORIZED REPRESENTATIVE <br /> TERRIE I. SNOWDEN, CPCU <br /> II R/ACORD CORPORATION 1985 <br />