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onnunign Envelope ID:nosEFCno-D47o-4nsa-8Ano*Aorennnc000 20CHAPEH|L3 <br /> A C O D" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) <br /> u2/O2/2O17 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.T*m <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:| 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 /> PRODUCER CONTACT <br /> BB&T Insurance Services Inc. Beth ��—� <br /> ' ' 19 2 U�� w� 888 746-8761 <br /> P�1O��Bon13�1 �=~' ' <br /> �G��o . uow||xors�nK�bbmndLcnm <br /> Durham, NC 27709 ~ --- ---- --- <br /> 919 281-4500 w'vnER(S)^rronDING COVERAGE wwcv <br /> 18058 <br /> INSURED Accident Fun�|nsCoo��merica 10166 <br /> Chapel HiUTraining Outreach Pn� Inc �---- --- �---- --- �----- <br /> 800Eas*ovvneDr Ste 1U5 ` ---- �---- ---� �----- -----� <br /> Chapel HiN. NC 27514 /'`` D'-- --- ---- ----�� ��----- ---- <br /> INSURER E/_� ��_-__' _---� ---- --- ------ <br /> INSURER,. <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: ' <br /> THIS IS TO CERTIFY THAT TEE POLICIES OF INSURANCE us/co BELOW HAVE BEEN ISSULD TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDILIONOF ANY CONTRACTOR 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 10 ALL THE <br /> TERMS,CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED o, PAID CLAIMS. <br /> �R y E OF IN <br /> o POLICY x .LIVIM/oov'rg LIMITS <br /> A � ~~~~^~'~^^^^~~~^''' pwpK1608480 0%0�2O1T02/�/3O1Ve^cno�cv���moc �1��0��O <br /> [ �| --- <br /> c��mo�^oc / "unr"u* "�) �1 �OOV0V <br /> wsos���'one�"��_ $20.000 <br /> PERSONAL&^u"INJURY o1.000,000 <br /> oEw'L^ooncsmsum/r^ppu�,psn� <br /> GENERAL AGGREGATE $3,000,000 <br /> POLICY p"o | | uo � --- _-_ <br /> �scr ' c PRODUCTS COMP/OE AGG $3.000.000 <br /> OnnER:__� ____ ` $ -- <br /> A ^urowpv/�s�mo/ur, PHPK1608480 02/05/2017 02/05/2O `1—�����----- <br /> 02/05/201: COMBINED /�,00o,0uV <br /> X ANY ALIT 0 BODILY INJURY $ <br /> ALL OWNED SCHEDULED <br /> � -- ---� �----- ---- � <br /> _ !eOmu/wwn,(p�_accident) $AUTOS , <br /> EPA w»w'»wms» � DAMAGE $ <br /> X HIRED ��� ^vroo Per accident) <br /> __--- <br /> ° <br /> A x UMBRELLA u^^ X OCCUR PHUB572135 02/05/2017 02/05/201: EACH $1 0Oo�D) <br /> sxcsSnu^o � o/�^��^o� --- <br /> / AGGREGATE $1 000,000 <br /> DED XI mET5NZww -----� <br /> ----���--- ---- ,& <br /> n <br /> WORKERS COMPENSATION ����--- ---��� <br /> B �mocmpu,,snu'u^a/�v' WCV6096247 12/17/2016 12/17/201 X � ��---- --- <br /> ^m.rnopncnOmp^n �"� � -�-~�'~'^ � ^ --- �-----' <br /> ���OFFICER/MEMBER w/^� � L�=���*^c�g��� ���),O0O___��� <br /> NH) -- <br /> ,,o", E�u/osAsE-��wr'o,cc $50O.VVV__ <br /> ,If yes,describe ESCRIPTION OF OPERATIONS below � E.L.DISEASE POLICY LIMIT $500.008 <br /> A Professional pHPK1608480 02/05/2017 02/05/2018 $1.000.000Qcc ---- <br /> Liability $3,000,000 Agg <br /> DESCRIPTION nr OPERATIONS/LOCATIONS/VEHICLES wCvnom,.Additional Remarks Schedule,may*,attached n=ore=ac°/°rey"/=*/ <br /> **Workers Comp Information^^ <br /> Other States Coverage <br /> Certificate Holder is included as additional insured, per written contract, as their interest may appear. <br /> ' . . <br /> CERTIFICATE HOLDER ' CANCELLATION <br /> Orange County Human Services SHOULD ANY or THE ABOVE DESCRIBED POLICIES as CANCELLED BEFORE <br /> THE EXPIRATION DATE r*snsop, NOTICE WILL BE DELIVERED IN <br /> Attn:Allen Coleman, PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough, NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> »�~�~ � <br /> � <br /> I � vv�� 7��- — k^ ©1xo14 ACORD CORPORATION,All rights reserved. <br /> ACORD 25(2014/01) 1 of The ACORD name and logo are registered marks of ACORD <br /> #S17581687/M17581383 BG3 <br />