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DocuSign Envelope ID:C7EABF72-ADAA-4072-B58C-21B9B8A9AF97 <br /> ` ! 2, DATE(MMfDDNYYY) <br /> AC O>RD CERTIFICATE OF LIABILITY INSURANCE 04/01/2019 <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 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 1-847-385-6800 CONTACT <br /> NAME; Jay Moroney <br /> Integro Insurance Brokers PHONE FAX <br /> Arc No,E,,,: 847 385 6800 IAIC,No)* <br /> 111 West Campbell E MAIL in <br /> ADDRESS: jay.moronsy@ tegrograup.cam <br /> 4 th Floor INSURERS AFFORDING COVERAGE NAIC# <br /> Arlington Heights, IL 60005 INSURERA: Scottsdale Ins CO and various Insurers <br /> INSURED INSURERS: <br /> Dixon Hughes Goodman LLP <br /> INSURER C <br /> 4350 Congress Street, Suite 900 INSURERD; <br /> INSURER E <br /> Charlotte, NC 28209 INSURERF: <br /> COVERAGES CERTIFICATE NUMBER: 55864935 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 /> INSR ADDL SUER POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE N O WVO POLICY NUMBER IMMIDDIYYYYI, MMIDDIYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S <br /> CLAIMS-MADE OCCUR A <br /> PREMISES Ea occurrence) S <br /> MEP EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 <br /> POLICY❑ PRO JECT ❑ LOC PRODUCTS-COMPIOP AGO 5 <br /> OTHER S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) 5 <br /> OWNED SCHEDULED 130DILY INJURY(Per accident) S <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE 5 <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> 5 <br /> UMBRELLRLIAB OCCUR EACHOCCURRENCE S <br /> HEXCESS LIAB CLAIMS-MADE AGGREGATE S <br /> DED RETENTIONS S <br /> WORKERS COMPENSATION I PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER <br /> ANYPRCPRIETORIPARTNERIFXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICERIMEMSEREXCLUbED7 El NIA - <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S <br /> If yes.descnbe under <br /> DESCRIPTION OF OPERATIONS below E-L.DISEASE-POLICY LIMIT S <br /> A Professional Liability HWS0000077 04/01/19 04/01/20 Each Claim 1,000,000 <br /> Annual Aggregate 1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Health Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 300 W. Tryon Street AUTHORIZED REPRESENTATIVE <br /> Hillsborough, NC 27278 <br /> USA —.- <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> Patty.Baxendale0integrogroup.cem_LEM <br /> 55864935 <br />