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DocuSign Envelope ID: 19BCEAA9-F982-42A7-972B-A7E79E20FF66 <br /> �1 CERTIFICATE OF LIABILITY INSURANCE =1r210M312018 <br /> monvrY} <br /> AC'+It�R� <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 endarsement(s). <br /> PRODUCER NAME, Angie Cox_ <br /> Capital Insurance& Financial Services,Inc, aPHONE Lt 919-571-0685_ r1c,N017 (919 571-0684 <br /> 3701 Lake Boone Trail AOOR �acox^capital-ins.Cam <br /> Suite 200 INSURERS A] FFCADING COVERAGE _,NAIC 0 <br /> Raleigh NC 27607 INSURER A; Philadelphia insurance Companies <br /> INSURED INSURER a: Travelers <br /> Medisolutlons Inc INSURERC: <br /> 1146 N Church St INSURER D: <br /> INSURER E: _ <br /> BURLINGTON NC 27217 INSURERF; <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 /> NSR TYPE OF INSURANCE POLICY NUMBER MMiODNYYYcyepid MMI OIYYVY LIMITS <br /> LTR <br /> GENERAL LIABILnY EACH OCCURRENCE $ 1000000DAMAGE TO RENTE <br /> X COMMERCIAL GENERAL I_IAaILrrY PREMISES Ea o=rre $ 100000 <br /> CLAIMS-MADE I OCCUR MED EXP(Any a�ersan} S 5000 <br /> A N N PHPK1742845 11/22/2018 11/22/2019 PERSONAL&ADV INJURY $ 1000000 <br /> ..,...... GENERAL AGGREGATE $ 2000000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2000000 <br /> 7C POLICY PRO-- LOG Sexual/Physical Abuse a 7000000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Eaaccdenl <br /> ANY AUTO BODILY INJURY IPer person) S <br /> ALL OWNED SCHEDULED SCOlLY INJURY(Per acddenl) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS IPer acrldenl3 <br /> UMBRELLA LIA6 H OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DEC) I I RETENTION$ $ <br /> WORKERS COMPENSATION x WC STATU- OTH• <br /> AND EMPLOYERS'LIABILITY YIN TO--X,. IS' ER <br /> ANY PROPRIETORIPARTNERIEXECUTIVE E-L.EACH ACCIDENT $ 100000 <br /> B OFFICERIMEMBER EXCLUDED? !Y N f A N UB 1 K06127 11/29/2018 1112912019 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100000 <br /> If my .describe under <br /> 0-SCRiPTION OF OPERATIONS below E-L-DISEASE-POLICY LIMIT s 500000 <br /> Professional Liability 1,000,000 each occurrence <br /> A N N PHPK174845 11/22/2018 11/22/2019 2 0g0,000 aggregate <br /> OESCRIPTION OF OPERATIONS(LOCATIONS 1 VEHICLES(Altach ACORO 101,AddItIonal Remarks Schedule,if more space m requ[red) <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 Government ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 113 Mayo St AUTHORIZED R€PRESENTATIVE <br /> Hillsborough NC 27278 <br /> ACORD 25(2010105) ©1988-2010 ACORD CORPORATION.All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />