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DocuSign Envelope ID: A3085305 -97D8- 438E- A223- 13AED5BFF65E <br />ACOR" CERTIFICATE OF LIABILITY INSURANCE <br />`6-„/" <br />DATE (MM /DD /YYYY) <br />11/14/2017 <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 <br />NAME: <br />Marsh Sponsored Programs <br />a division of Marsh USA Inc. <br />PO Box 14404 <br />PHONE FAX <br />AIC No Ext:800- 338 -1391 AIC,No.:888- 621 -3173 <br />E -MAIL <br />ADDRESS .acecclientrequest @marsh.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC# <br />Des Moines IA 50306 <br />INSURER A: Hartford Accident & Indemnity Co <br />22357 <br />$1,000,000 <br />INSURED <br />INSURER B: Sentinel Insurance Company Ltd <br />11000 <br />Reece Noland & McElrath Inc. <br />GENERAL AGGREGATE <br />INSURER C' <br />GENT AGGREGATE LIMIT APPLIES PER <br />POLICY PRO - <br />X J LOC <br />94 Main St. <br />Canton, NC 28716 <br />INSURER D' <br />INSURER E' <br />A <br />AUTOMOBILE <br />INSURER F' <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 />INSR <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDD /YYYY <br />POLICY EXP <br />MMIDD /YYYY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE XI OCCUR <br />84SBWVM4602 <br />Prof. Liab. Excl. <br />11/01/2017 <br />11/01/2018 <br />EACH OCCURRENCE <br />$1,000,000 <br />PREMSESO(Fa occurrence <br />$1,000,000 <br />MEDEXP (Any one person) <br />$10,000 <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />GENERAL AGGREGATE <br />$2,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER <br />POLICY PRO - <br />X J LOC <br />PRODUCTS - COMP /OPAGG <br />$2,000,000 <br />$ <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />HIRED AUTOS X AUTOS <br />84SBWVM4602 <br />11/01/2017 <br />11/01/2018 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />X <br />PROPERTY DAMAGE <br />Per accident) <br />$ <br />$ <br />A <br />X <br />UMBRELLA LAB <br />EXCESS LAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />84SBWVM4602 <br />11/01/2017 <br />11/01/2018 <br />EACH OCCURRENCE <br />$1, 000, 000 <br />AGGREGATE <br />$1, 000, 000 <br />DED I X I RETENTION $10,000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR /PARTNER /EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />84WBGBA2007 <br />11/01/2017 <br />11/01/2018 <br />X WC OTH- <br />X TORY LIMITS I ER <br />F.L. EACH ACCIDENT <br />$500,000 <br />F.L. DISEASE - EA FMPLOYFE1 <br />$500,000 <br />F.L. DISEASE - POLICY LIMIT <br />1 $500,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />Orange County <br />PO Box 8181 <br />Hillsborough, NC 27278 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE * .✓ <br />© 1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />