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DocuSign Envelope ID: A899BE5E- BAEC- 40F3 -9l E1- A9D77FC4C488 <br />ELCENTR -04 SPIKE <br />'ACC]RU CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM /DD /YYYY) <br />08/14/2018 <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 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 <br />CONTACT <br />NAME: <br />PHONE FAX <br />(A/c, No, Ext): (919) 337 -0000 (A/c, No):(866) 553 -5124 <br />Hub International Carolinas <br />E -MAIL <br />ADDRESS: <br />PHPK1802727 <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />EACH OCCURRENCE <br />INSURER A:Philadelphia Indemnity Insurance Company <br />18058 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />INSURED <br />INSURER B : <br />MED EXP (Any one person) <br />INSURER C : <br />El Centro Hispano, Inc. <br />INSURER D: <br />$ 1,000,000 <br />600 East Main Street <br />Durham, NC 27701 <br />INSURER E <br />$ 2,000,000 <br />INSURER F: <br />$ 2,000,000 <br />COVERAGES CERTIFICATE NUMBER: 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 />IN SD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM DD <br />POLICY EXP <br />MM DD <br />LIMBS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F_X] OCCUR <br />PHPK1802727 <br />04/06/2018 <br />04/06/2019 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea occurrence <br />100,000 <br />MED EXP (Any one person) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY JERCOT F—] LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP /OPAGG <br />$ 2,000,000 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY Per person) <br />$ <br />BODILY INJURY Per accident <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />• <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />PHUB624430 <br />04/06/2018 <br />04/0612019 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />AGGREGATE <br />$ 1,000,000 <br />DIED I X I RETENTION $ 10,000 <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR/PARTNER/EXECU I IVE ❑ <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />PER OTH- <br />STATUTE I ER <br />E.L. EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />• <br />• <br />Crime <br />Professional Liabili <br />PHPK1802727 <br />PHPK1802727 <br />04/06/2018 <br />04/06/2018 <br />04/06/2019 <br />04/06/2019 <br />Employee Dishonesty <br />Each Incident <br />120,000 <br />1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Professional Liab Aggregate $3,000,000 <br />Sexual or Physical Abuse or Molestation Vicarious Liability $1,000,000 per claim, $1,000,000 Aggregate <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2016/03) © 1988 -2015 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 Count Government <br />9 Y <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />200 S Cameron St <br />PO Box 8181 <br />AUTHORIZED REPRESENTATIVE <br />Hillsborough, NC 27278 <br />ACORD 25 (2016/03) © 1988 -2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />