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DocuSign Envelope ID: D6ED5842-3296-4CBF-953B-BD73BFOOC8D1 CERTIFICATE OF LIABILITY INSURANCE D06/1ATE //2019 06/12/2019 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 policy(ies)must 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 CONTACT Krista Dean NAME: Altus Partners, Inc A/CNNo Ext: (610)526-9130 FAX NU: (610)526-2021 919 Conestoga Road E-MAILs: certs@altuspartners.com ADDRES Building 3, Spite 311 INSURERS AFFORDING COVERAGE NAIC# Rosemont PA 19010 INSURER A:Lloyds of London 2623/623 INSURED INSURERB:ACE American Ins. Co. 22667 Maxim Healthcare Services, Inc. INSURERC: d/b/a Maxim Staffing Solutions INSURERD: 7227 Lee DeForest Drive INSURER E: Columbia MD 21046 INSURER F: COVERAGES CERTIFICATE NUMBER:Staffing Std +XS REVISION NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SD WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 A X CLAIMS-MADE OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ X $3,000,000 SIR X PH1807054 11/30/2018 11/30/2019 MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY ❑ PRO JECT ❑ LOC Products PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: Exclusion $ AUTOMOBILE LIABILITY CEa acOMBINED SINGLE LIMITcident $ 1,000,000 B ANYAUTO H25274799 (Owned Auto) BODILY INJURY(Per person) $ X ALL OWNED SCHEDULED H25274830 11/30/2018 11/30/2019 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIREDAUTOS X AUTOS Per accident) ccident $ X UMBRELLA LIAB OCCUR PH1807054 11/30/2018 11/30/2019 EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB X I CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION $ $ WORKERS COMPENSATION C65439037 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE C65439074 (CA, MA) E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N❑ N/A B (Mandatory in NH) C65438951 (WI) 11/30/2018 11/30/2019 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below C65438999 (OH, WA) E.L.DISEASE-POLICY LIMIT $ 1,000,000 D A Professional Liability PH1807054 ($4M SIR) 11/30/2018 11/30/2019 $4,000,000 per claim/Agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate is issued as evidence of insurance per policy terms, conditions and exclusions. Certificate holder is an additional insured on the general liability insurance policy where required by written agreement prior to loss. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE Krista Dean/KMD ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)