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DocuSign Envelope ID: 1E2AAD35 -CBEC- 4533- B8C2- A8D2EEC354B4
<br />ACC? " CERTIFICATE OF LIABILITY INSURANCE
<br />DATE (MM /DDNYYY)
<br />3/12/2018
<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 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
<br />CONTACT Diane Nadeau
<br />NAME:
<br />AHCNNO Ext: (919) 968 -4611 ,AX No: (919)968 -8991
<br />Business Insurers of Carolinas
<br />E -MAIL dnadeau @business - insurers.com
<br />ADDRESS:
<br />800 Eastowne Drive, Suite 208
<br />PO BOX 2536
<br />INSURERS) AFFORDING COVERAGE
<br />NAIC #
<br />INSURERA:The Hanover Insurance Group, Inc.
<br />Chapel Hill NC 27515 -2536
<br />INSURED
<br />INSURER B:
<br />CLAIMS -MADE � OCCUR
<br />INSURER C :
<br />Longent LLC
<br />INSURER D:
<br />7250 ACC Blvd.
<br />INSURER E:
<br />$ 300,000
<br />INSURER F:
<br />$ 10,000
<br />Raleigh NC 27617
<br />COVERAGES CERTIFICATE NUMBER:17 -18 PKG, Auto, UMB, WC REVISION NUMBER:
<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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />SUBR
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM /DD/YYYY
<br />POLICY EXP
<br />MM /DDNYYY
<br />LIMITS
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />A
<br />CLAIMS -MADE � OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />$ 300,000
<br />MED EXP (Anyone person)
<br />$ 10,000
<br />ZZ6- D355194 -01
<br />8/29/2017
<br />8/29/2018
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMIT APPLIES PER:
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY jEO- LOC
<br />PRODUCTS - COMP /OPAGG
<br />$ 2,000,000
<br />Employee Benefits
<br />$ 1,000,000
<br />OTHER:
<br />AUTOMOBILE
<br />LIABILITY
<br />COEa M acBINED SINGLE LIMIT cident
<br />$ 1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />A
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />AW6- D355264 -00
<br />8/29/2017
<br />8/29/2018
<br />BODILY INJURY (Per accident)
<br />$
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />NON -OWNED
<br />HIRED AUTOS AUTOS
<br />Medical payments
<br />$ 5,000
<br />X
<br />UMBRELLA LIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 10, 000, 000
<br />A
<br />EXCESS LIAB
<br />CLAIMS -MADE
<br />DED I X RETENTION$ 10,000
<br />$
<br />UH- D355198 -00
<br />8/29/2017
<br />8/29/2018
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY YIN
<br />X PER OTH-
<br />STATUTE ER
<br />A
<br />ANY PROPRIETOR /PARTNER /EXECUTIVE
<br />OFFICER /MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />N/A
<br />WD6- D279800 -00
<br />8/29/2017
<br />8/29/2018
<br />E.L. EACH ACCIDENT
<br />$ 1,000,000
<br />E.L. DISEASE- EA EMPLOYE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT
<br />$ 1,000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />CERTIFICATE HOLDER CANCELLATION
<br />ACORD 25 (2014/01)
<br />IN S025 (201401)
<br />© 1988 -2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Orange County
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />PO Box 8181
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Hillsborough, NC 27278
<br />AUTHORIZED REPRESENTATIVE
<br />James Knauff, IV /NADA �]
<br />ACORD 25 (2014/01)
<br />IN S025 (201401)
<br />© 1988 -2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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