2018-381-E DSS - MediSolutions in-home aide services

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DocuSign Envelope ID: 3E4B4B91- 8AA8 -41 OB- 8584- 1IAAECCBC787 ,-- -1 e '4CR 0 CERTIFICATE OF LIABILITY INSURANCE DATE (MMIODNYYY) 7/24/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the Certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Morgans & Associates LLC - GA PO Box 456 Kennesaw GA 30156 NAME: Donald Morgan _ AIC, No, No : 7798617509 ( VC, No): 1 -866 -713 -5171 ADDRfsa: dmorgan@maginsurance.com INSURER(S) AFFORDING COVERAGE NAIL # INSURER A; EVANSTON INS CO 35378 INSURED Medlsoultion 100 N Church ST Burlington NC 27217 INSURER B: NP343324 INSURER C; 07/1512019 INSURER D; 5 1,000,fl00 INSURER E: PREMISES Es occurrence INSURER F: MEO EXP (Any one person) rnwc:oAn=a rrC92TIFIr'ATG MWARFR• REVISION NUMBER: v THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE INSD MD POLICY NUMBER MMIODNYYYI (MMIDDMM) LIMITS A X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE El OCCUR NP343324 07115/2018 07/1512019 EACH OCCURRENCE 5 1,000,fl00 PREMISES Es occurrence S 100,000 MEO EXP (Any one person) $ 5,000 PERSONAL BADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY O PRO- POLICY 7 LOC OTHER; GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPICP AGG $ 1,000,000 Sexual and Physical Abus $ 1,000,000 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIREO NON -OWNED AUTOS ONLY AUTOS ONLY (Ea acchient] $ BODILY INJURY (Per parson) $ BODILY INJURY (Per accident) $ Per accEdenl] _ $ $ UMBRELLA LIAR EXCESS LIAB OCCUR OLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ ORKERS COMPENSATION NO EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE F7 OFFICERIMEMBER EXCLUDED? IMandatory In NH) f yyes, descrlbe under DESCR€PTION OF OPERATIONS below NIA _ PER STATUTE ER E,L. EACH ACCIDENT $ E,L, DISEASE - EA EMPLOYEE - - E,L, DISEASE - POLICY LIMIT $ A Sexual Misconduct/Molestation/Abuse NP343324 07/15/2018 07/15/2019 $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS F VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) CERTIFICATE HOLDER S.:ANUr_LLAIIIlN Orange County Goverment P.O. Box 8181 Hillsbor"gh, NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE D&Ka . J Margaw tJ 19t5t5 -ZU1 5 Ai.;UKU UVKIIF -UIiA I IUN. Ali rlgms reserveaz. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD