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DocuSign Envelope ID: E7F88FC1-7C61-4E68-8AF9-5870F711DEBC <br /> OP ID: DS <br /> A� ' CERTIFICATE OF LIABILITY INSURANCE GATE o3117r2a1s1712016 <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 CONTACT <br /> Higgh&Rubish Insurance Agency NAME: <br /> P.O Box 3040 PHONEx <br /> AIC No Ext: LAIC <br /> 6015 Farrington Rd.Ste 101 S: <br /> Chapel Hill,NC 27517 ADDRES ADDRESEIi --- <br /> High&Rubish FRODCCUSTOMER ID R:HELPI-1 <br /> INSURER(S)AFFORDING COVERAGE NAIL V <br /> I.NSiJRED A Helping Hand 27707 INSURER A.Cincinnati Insurance Companies 10877 <br /> Durham, NC <br /> D urh am Hwy Ste 405 INSURER B..U.S.Liability Insurance Co. <br /> INSURER C <br /> INSURER D; <br /> INSURER E <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 /> LTRR TYPE OF INSURANCE IH&&WVD POLICY NUMBER MMIODIYYY _ (MMIDONYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> A L. <br /> X COMMERCIAL GENERAL LIABILITY HHC0005W 0310112016 03/0112017 PREMISES Ea ccsurrence $ 100,000 <br /> CLAIMS-MADE FX_1 OCCUR MED EXP(Any one perm) $ 10,000 <br /> PERSONAL a ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GENt AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 <br /> PIOLICYFI PRa LOC _ $ <br /> AUTOMOBILE uA61LrrY COMBINED SINGLE LIMIT $ 1,000,000 <br /> (Ea accident) <br /> ANY AUTO <br /> BODILY INJURY(Per parson) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Per accitlenl) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> A �HIRED AUTOS HHC000588 03101/20/6 0310112017 (PER ACCIDENT) $ <br /> +X NON-OWNED AUTOS $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIA6 'CLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION WC STATU- TH- <br /> AND EMPLOYERS'LIABILITY YIN TORY LIMITS PER <br /> ANY PROPRIETORIPARTNERIEXECUTNE E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? NIA <br /> (Mandatory In NMI E.L.DISEASE-EA EMPLOYE $ <br /> If yes,deSer'be erMder <br /> ❑ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ <br /> B Professional Liab NDO10541771 '09/0912016 0910912D17 11000,000 <br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(Attach ACORD 101,AddltIonal Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANIG-3 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Government ACCORDANCE <br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 South Cameron Street <br /> P.O. Box 8181 <br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE <br /> O 1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD <br />