2019-630-E DSS - CNC Access ResCare in home services contract amendment

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DocuSign Envelope ID: B7EA7F20-FBF8-4080-B439-2B07E37432E0 ACdRD° CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDD/YYYY) 7/1/2020 1 6/13/2019 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 WSURER(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 endorsement(s). CONTACT PRODUCER LOCKTON COMPANIES NAME: 2100 ROSS AVENUE,SUITE 1400 PHONE DALLAS TX 75201 Arc,No,Ext: Arc No E-MAIL 214-96M700 ADDRESS: INSURER(Sl AFFORDING COVERAGE NAIC# INSURER At ACE American Insurance Company 22667 INSURED ReS-Care,Inc. INSURER B: endurance American Insurance Company 10641 1078748 805 N.Whittington Parkway INSURER c; See Attached Louisville ICY 40222 INSURER D INSURER E INSURER F: COVERAGES *RESCAOI P* CERTIFICATE NUMBER. 12696764 REVISION NUMBER: XXXXXXx 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 ADDL Sl1RR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MIDn1YYYY (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY N N XSL G71567242 7/I/2C19 7/1/2020 EACH OCCURRENCE s 4,00U 000 A CLAIMS-MADE❑OCCUR (CLAIMS MADE) DAEMAGE TO RENTED 300 D00 x MISES Ea occurrence x Praf.l.sability MED EXP Any oneperson) Xxxxxxx X SexAbuse/Molestation _ PERSONAL&ADV INJURY s 4,000,000 GEN'LAGGRE.GATE LIMIT APPLIES PER GENERAL AGGREGATE $ 6,000 000 ]f POLICY❑JECT LOC PRODUCTS-COMPIOPAGG $ 4,000 000 OTHER: $ A AUTOMOWLE LIABILITY N N ISAH25296953 7/1/2019 7/l/2020 CO aBINEDDISINGLE LIMIT $ 2,OOQ 000 X ANYNAUTO SCHED BODILY INJURY(Per person) $ XXXI ALTOS ONLY AUTOSULED BODILY INJURY{Par accident $ }MxxxX Hl T%D NON-OWNED PROPERTY 7AMAGE x ALIT S ONLY x AUTOS ONLY Per accident $ xxx-xxxx $ xxxxxxx B UMBRELLA LIAB x OCCUR N N XSC30000119103 7/1/2019 7/1/2020 EACH OCCURRENCE $ 3 000,000 B EXCESS LIAR CLAIMS-MADE (AUTO&EL ONLY) AGGREGATE $ XXxxxxx DED I I RETENTION$ s xxxxxxx C AND EMPLOYERS'LIABILITY YIN N SEE ATTACHED x STATUTE E R OFFICERIMEM Eft EXCLUDE{ANY 7 C�1 N7 N f A VE E.L.EACH ACCIDENT $ 2,000,000 IManda"In NHl E.L.DISEASE-EA EMPLOYEE 2,000,000 If yes,descdbe uMer 11 ran DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 2,000,000 DESCRIPTION OF OPERATIONS r LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is requi red I Retro Date f'or Policy NXSL G71567242 is 7/1/01.CNCIAccess,Inc dba ResCare 11onicCarc a stibsidiary of ResCare,Inc. CERTIFICATE HOLDER CANCELLATION See Attachment SHOULI)ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12696764 AUTHORIZED REPRESENTATIVE Orange County 113 Mayo St. Hillsborough NC 27278 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION.All rights reserved The ACORD name and logo are registered marks of ACORD