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DocuSign Envelope ID:23F621AB-7298-4E36-B826-B670C6D009B1 OWE(MMWDIYY`M <br /> f'►�`ao CERTIFICATE OF LIABILITY INSURANCE <br /> µ 05I2112018 <br /> TWIS 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,E)[TEND ORALTERTHE COVERAGE AFFORDED BYTHE 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 certMeate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER OONTACT Barf]ara Hoover <br /> RAHE <br /> Lester Ins.Group,Inc.TIA The Harper Agency PHOHH AX <br /> . (336)227-4271 iuc No): (336)222-W7 <br /> 1037 S.Main St. E-MAIL Rss: barby.hoover@harpednsurance.com <br /> I HSU RER(S)A!`FDRDI NG COVERAGE NAIL i <br /> Sudinglan NC 27215 INSURER A: Beazley Insurance Company <br /> INSURED INSURER B: <br /> Happy Homecare Staffing Inc_ INSURER C: <br /> 6720 Pentecost Rd. ■NSURER D <br /> INSURER E <br /> Cedar Grove INC 27231 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CL1852109158 REVISION NUMBER: <br /> THIS IS TO CERTIFY T-IATTHE 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 MAYBE 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 /> I�TR TYPE OF INSURANCE INSD 1IYVD POLICY NUMBER N V Y EFF P ICY 4D' <br /> urns <br /> COMMERCIAL GENERAL LIABILITY FACH OCCURRENCE $ 1,000,000 <br /> CLAWS-MADE OCCUR PREMISES P ooaprenoe S 50,000 <br /> MED FXP(Any one person) S 5,000 <br /> A V221SC180101 03/15/2018 03/15/2019 -PERSONAL BADVINJURY $ 1.000.000 <br /> GEN'LAGGREGATE LIMITAPPUES PER GENERALAGGREGATE $ 2,000.000 <br /> POLICY El VICT LOC PRODUCTS-COMPIOPAGG S 2,000.000 <br /> OTHER: Professional Liability $ 1,000.000 <br /> CO <br /> AUTOMOBILE LIABILITY COMBINED SINGLE UMff $ <br /> a acddnnL <br /> ANYAITTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Peraoddenl) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE ; <br /> AUTOS ONLY AUTOS ONLY eracddenL <br /> $ <br /> UMBRELLA L1AB OCCUR EACH OCCURRENCE $ <br /> 4 EXCESS LJAB CLAIMS-MADE AGGREGATE $ <br /> DEO I I RETENnON$ r $ <br /> WORICERS COMPENSATION PER CM+ <br /> AND EMPLOYERS LLASUTY YIN STATUTE ER <br /> ANY PROPRIETORIPARTNER1EXECUTNE ❑ NIA EL EACH ACCIDENT $ <br /> OFFICERIMEMOER EXCLUDED? <br /> (MandabMinNHI EL DISEASE-EA EMPLOYEE $ <br /> byes,de 'be under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 141,Addrdonal Remarks Schedule,may be attached it more space is"uimd) <br /> Includes Sexual Molestation$250.000 per Incident and$750,00 0 An nua I Aggregate. <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 Social Services ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P0 Box at81 <br /> AUTHORIZE!)RP..INRESENTATIVE <br /> Hillsborough NC 27278 _s. <br /> D 1988-2015 ACORD CORPORATION. All rights reserved, <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />