2019-454-E Health - El Futuro mental health services

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DocuSign Envelope ID:44FOD66E-1905-4A6D-B2D2-D7CO2EDF751A ---MOWN ELFUTUR-01 KRHODE ,a►corro CERTIFICATE OF LIABILITY INSURANCE DATE 01 11 8120 1 9 olrlsrzQls 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 have ADDITIONAL INSURED provisions or 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 endomement(s). PRODUCER C CT Joel T.Cheatham,Inc. PNONE Fax 106 W Winder St Arc,Na,Ett: 252)43$-5111 Arc,Na:(252)430-1229 Henderson,NC 27536 E INSURERS AFFORDING COVERAGE NAIC N INSURER A-Scottsdale Insurance Company 41297 INSURED INSURER B: El Futuro,Inc. INSURERC: 2020 Chapel Hill Rd Suite 23 INSURER D: Durham,NC 27707 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SUER POLICY NUMBER POLICY EFF POLICY ExP LIMITS A X f COMMERCUIL GENERAL LIABJUTY EACH OCCURRENCE S 1,000,000 I CLAIMS MADE �OCCUR X OPS0069495 1010612018 10/0612019 DAMAGE TO RENTEDPREMSESE. S 300,000 MED EXP armperson) $ 51000 PERSONAL&ADV INJURY $ 1,000,000 GEITL AGGREGATE LIMIT APPLIES PER- GENERAL AGGREGATE S 3,000,000 X POLICY El im 0LOG PRODUCTS-COMPIOP AGG S 3,000,000 OTHERS S A AUTOMOBILE LIABILITY COMBINED SINGLE LIMB 1,000,005 ANY AUTO OPS0069495 10105/2018 10/0512019 BODILY INJURY Per pmwl S OWNED SCHEDULED AUTOS ONLY AUTOS y ED BODILY INJURY Per accident S X A"I SONLY X AUTO%ONLY �eraE�� GE $ $ UMBRELLA—i LIAR OCCUR EACH OCCURRENCE s EXCESS LUIB HCLAIMS-MADE AGGREGATE S !DED I 1 RETENTIONS S WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY Y I N ANY PRROR��PMMRIIETgO�R�IPARTNERIEXECUTIVE E L.EACH ACCIDENT S �anjE 1IMgn NHj EXCLUOED7 N 1 A E L DISEASE-EA EMPLOYE S H yyes,describe under DESCRIPTION OF OPERATIONS below E L DISEASE-P LI Y LIMIT A Professional Liab OPS0069495 1010512018 10/0612019 Ea Claim 1,000,000 A Professional Liab OPS0069495 10105/2018 10/0512019 Aggregate 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,AddlUonal Remarks Schedule,may be attached if more apace Is M u�lndl Certificate holder Is additional Insured under the General Liability,but only with respects to operations of the Named Insured.Sexual Misconduct Sublimit $1,000,000 Each claim 1$2,000,000 Aggregate Please see attached binder for Data Breach Liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Attn:Finance Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty P ACCORDANCE WITH THE POLICY PROVISIONS. 200 S Cameron Street PO Box 8181 Hillsboro,NC 27278 AUTHORIZED REPRESENTATIVE ACORD 25(2016103) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD