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DocuSign Envelope ID:96EAAE81-6F3C-4C19-90BO-81AAOF1D1360 <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MNElOD7YYYY} <br /> A�dRD <br /> 08/26/2019 <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 he 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 CONTAME;CT <br /> NA <br /> Hiscox Inc. PHaNE (888)202-3007 FAX Ho <br /> 520 Madison Avenue E-MAIL <br /> ADDREss: cantactChiscox,com <br /> 32nd Floor <br /> New York,NY 10022 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A: Hiscox Insurance Company Inc 10200 <br /> INSURED INSURER B: <br /> Margaret Toe <br /> 611 INSURER C <br /> Dupree St. INSURERD: <br /> Durham NC 27701 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 CONDITtON 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 TYPE INSURANCE ADDL S 9R POLICY NUMBER MM POLICY <br /> EFF POLICY EXP MMIDDNYYY LIMITS <br /> 4TR <br /> COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE S <br /> A T N D <br /> CLAIMS-MADE OCCUR PREMISES Ea occurrence $ <br /> MED EXP(Anyone raon) $ li <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> POLICY JEC° 7 LOC -PRODUCTS-COMPIOPAGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COM BIN ED 3 INGLE LI MIT $ <br /> Ea eocldent <br /> ANY AUTO <br /> BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per aoddent) $ <br /> AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Per acnldernt <br /> UMBRELLA OAS OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION PERTUTE� OTH- <br /> AND EMPLOYERS'LIABILITY <br /> YIN <br /> ANYPROPRIETORIPARTNERfE7fECUTIVE NIA <br /> E.L.EACH ACCIDENT S <br /> OFFICERIMEMB ER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEq S <br /> H yes,describe under <br /> pESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S <br /> A Professional Liability UDC-2009323-EO-19 07/0112019 07/01/2020 Each Claim:$250,000 <br /> Aggregate:$250,000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additivnal Ram arks Schedule,may be attach ad I mom 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 /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD <br />