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DocuSign Envelope ID:64B57AAO-E577-48A7-A2AD-05217CDOF7DB <br /> �® DATE(MMIDDIYYYY) <br /> ��. CERTIFICATE OF LIABILITY INSURANCE 05r1712019 <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 /> NAME: <br /> HISCDx Inc. PHONE �888)202_3007 AIC No): <br /> 520 Madison Avenue E-MAIL <br /> 32nd Floor ADDRESS: contact@hiscox.com <br /> New York,NY 10022 INSURERS AFFORDING COVERAGE NAIL0 <br /> IWURERA; Hiscox Insurance Company Inc 10200 <br /> INSURED INSURER B; <br /> Benjamin Beaton <br /> 107 James Helen Ct. INsuRERc <br /> Willow Spring INC 27592 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 /> ILLTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/ODIYYYY MMIDDIYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGE TO RENTEW-- <br /> CLAIMS-MADE OCCUR PREMISES(Ea occurrance) $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY jE� F—ILOC PRODUCTS-COMPIOPAGG $ <br /> OTHER: $ <br /> AUTOMOBILELIABILnY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO <br /> BODILY INJURY(Perpumon) $ <br /> ALL OWNED SCHEDULED SOD ILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS acciden <br /> $ <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y 1 N STATUTE ER <br /> ANYPROPRIETORIPARTNERIEXECUTIVE ❑NIA <br /> E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBEREXCLUDED7 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> IF yes,describe under E.L.DISEASE-POLICY L1MIT $ <br /> ❑ESCRIPTION of OPERATIONS below <br /> A Professional Liability UDC-1774785-EO-19 07/01/2019 07101/2020 Each Claim:$250.000 <br /> Aggregate;$250,000 <br /> DE SCRIPTTON OF OPERATIONS I LOCATI DNS I VEHICLES{ACORD 101.Additional Remarks Schedule,may be attached If more 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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> 1 <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014101) The ACORD name and Toga are registered marks of ACORD <br />