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DocuSign Envelope ID:044AD186-BAD7-4A1 B-B44F-162B7511 D3DF <br /> CERTIFICATE OF LIABILITY INSURANCE DATE I MMIDDfYYYY) <br /> 031I 512019 <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 INSURERS), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the palicy(ies)must be endorsed. If SUBROGATION 1S WAIVED,subject to the <br /> 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 Eva Noyce <br /> NAME: <br /> Mercer Consumer,a service of PHONE: 800-523.9345 <br /> Mercer Health&Benefits Administration LLC AIC,No): <br /> EMAIL FAX <br /> 800 W.Main Street,Suite#1250 ADDRESS: eva.I.rloyce@meresr.00m No): 208-338-6485 <br /> Boise, ID 83702 PRODUCER <br /> CUSTOMER ID: <br /> INSURERS AFFORDING COVERAGE NAIC ik <br /> INSURED INSURER A: Westchester Fire Insurance Company 21121 <br /> Communication Access Partners,Inc. INSURER B: <br /> 950 Graves Street INSURER C: <br /> Unit A <br /> Kernersville, NC 27284 INSURER D: <br /> INSURER E: <br /> INSURER R <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 /> INS TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LETFi MMIDDIYY MMIDDfYY] <br /> GENERAL LIABILITY EACH OCCURENCE $ <br /> ❑COMMERICAL GENERAL LIABILITY DAMAGE TG RENTED $ <br /> PREMISES Ea occurrence <br /> ❑❑CLAIMS-MADE ❑OCCUR MED EXP[Any one person] $ <br /> ❑— PERSONAL&ADV INJURY $ <br /> ❑-- GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LI MIT APPLIES PER: <br /> El POLICY❑PROJECT❑ LOC PRODUCTS-COMPlDP AGG $ <br /> $ <br /> AUTOMOBILE LIABILITY cOM8INED StNGLE1JMIT $ <br /> (Each Occurrence] <br /> RODILY INJURY <br /> ANY AUTO (Per person) $ <br /> ❑ALL OWNED AUTOS BODILY INJURY <br /> [Per acddenll $ <br /> ❑SCHEDULED AUTOS PROPERTY DAMAGE <br /> ❑HIRED AUTOS (Peracddenl} <br /> ❑NON-OWNED AUTOS $ <br /> ❑ UMBRELLA LIAR ID OCCUR <br /> EACH OCCURRENCE: $ <br /> ❑ EXCESS LIAR CLAIMS-MADE <br /> AGGREGATE: $ <br /> ❑ DEDUCTIBLE $ <br /> ❑ RETENTION$ $ <br /> WORKERS COMPENSATION YIN <br /> NIA ❑WC DRY ATU- ❑OT <br /> AND EMPLOYERS'LIABILITYER <br /> ANY PROPRIFTORIPARTNER!EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICERYMEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,dascribe under <br /> DESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT $ <br /> A OTHER G24376874007 03/18/2019 03/18/2020 Meets 1 Mil. Each claim 13 Mli.Aggregate limit <br /> Professional Liability Insurance <br /> Claims Made <br /> Retroactive Date:0311 8/20 1 3 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Communication Access Partners, Inc. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 950 Graves Street ACCORDANCE WITH THE POLICY PROVIS[ON S. <br /> Unit A AUTHORIZED REPRESENTATIVE <br /> Kernersville, NC 27284 <br />