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DocuSign Envelope ID:7C495125-6619-47FC-AA13-CEF385D97245 <br /> I ONTAR-1 OP ID: HLB <br /> .44cORi7 FDATE(MM/DD/YYYY) <br /> 16.. � CERTIFICATE OF LIABILITY INSURANCE 07/11/2019 <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 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 /> INSURANCE SERV CTR -CLINTON NAME: LAMAR BUTLER, CIC <br /> CLINTON BRANCH a/cN o Ext:910-592-3108 (FAX No:910-401-9244 <br /> Box 4 INCE-MAIL <br /> SS:(butler@iscfay.com <br /> CLINTON,, 28329 AD <br /> LAMAR BUTLER INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA:THE HARTFORD 22357 <br /> INSURED ON TARGET PREPAREDNESS INSURERB: <br /> 266 BRADDOCK DR <br /> LILLINGTON, NC 27546 INSURERC: <br /> 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 /> INSR TYPE OF INSURANCE DDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> CLAIMS-MADE FXIOCCUR 22SBAUN2187 08/01/2018 08/01I2019 DAMAGE TO RENTED- <br /> PREMISES Ea occurrence $ 300,00 <br /> MED EXP(Any one person) $ 10,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 <br /> X POLICY PRO- <br /> JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COEa acMBcINED SINGLE LIMIT ident $ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DIED RETENTION$ $ <br /> WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 22WBCCT8451 08/01/2018 08/01/2019 E.L.EACH ACCIDENT $ 500,00 <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/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 /> ORANGE CO. HEALTH DEPT. ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 2501 HOMESTEAD RD <br /> CHAPEL HILL, NC 27516 AUTHORIZED REPRESENTATIVE <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />