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DocuSign Envelope ID:A29F932E-B736-4874-9F31-38ED64EA3F59 <br /> A`COR" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIrIDlYYYY) <br /> 1113012018 <br /> THIS CERTIFICATE I5 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(les)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 coNTAcT Business Service <br /> NAME: <br /> Pelnik Insurance H No Ext (919)459-8000 RIC Na. (866)714-3576 <br /> (AI100 Ridgeview Drive E-MAIL Business.Service@Peinik.com <br /> ADDRESS; <br /> Suite 100 1 NSURER(S}AFFORDING COVERAGE NAIC p <br /> Cary NC 27511 INSURERA: Erie Insurance Exchange 26271 <br /> INSURED INSURERB: BerkleyAssuranceCom pan y <br /> FIRM FOUNDATIONS INSURERG: <br /> TERRYASHE DIBIA INSURERD: <br /> 1102 HERBERT DR INSURER <br /> ZEBULON NC 27597-9522 INSURERF: <br /> COVERAGES CERTIFICATE NUMBER: CLIS113017553 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAYBE 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 /> ILTR TYPEOFINSURANCE ADDLISUBRI POLICYNUMBER MMIdCYDdYYYY MMODIDIYYxYY LIMITS <br /> INSD N/1iD <br /> X COMMERCIAL GENERAL LIABILITY RRENCE $ 11000,000 <br /> EACH OCCU <br /> CLAWS-MADE O OCCUR PREMISES Ea o=rrence $ 1,D00,000 <br /> MED ExP(Anyone arson $ 10,000 <br /> A Y Q32-0102260 08101/2018 0810112019 PERSONALBAOV INJURY $ 1,000,000 <br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2.000,000 <br /> X POLICY JEa LOD PRODUCTS-COMPIOPAGG $ 2,000,00D <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLELIMIT $ <br /> Ea accident <br /> ANYAUTO BODI LY I NJ U RY(Per person) $ <br /> OWNED SCHEDULED BODILYINJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per awdent <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEO I I RETENTION$ <br /> WORKERS COMPENSATION I PER OTH- - -- <br /> AND EMPLOYERS`LIABILITY Y J N STATUTE ER <br /> ANY PROPRIETORIPARTNERIEXECUTIVE ❑ NIA E,L,EACH ACCIDENT $ <br /> OFFICERlMEMBER E7(CLUDED7 <br /> Mandatory lnNH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,dascn'8a under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> General Aggregate: $1,000,000 <br /> Professional Liability <br /> B Errors and Omissions VUMA0189440 11129/2018 1112512019 Each Occurrence; $1,000,000 <br /> DESCRIPTION OF OPERATIONS;LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedu[a,may be attached it mono space Is required] <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Orange County Housing Program ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P,O.'Box 8181 <br /> AUTHORIZED REPRESENTATIVE Hillsborough NC 27278 M04b;1 Q I,r-�w Q 1988.2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />