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DocuSign Envelope ID:75C616E5-76E4-43AA-986C-053F34F85F83 <br /> A`R o® CERTIFICATE OF LIABILITY INSURANCE DATE`MMroDIrYYY) <br /> 0612412019 <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 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CON A Barbara Hoover <br /> NAME! <br /> Lester Ins.Group,Inc.T1A The Harper Agency PHONE {336}227-427i FAxAIC Me): (336)222-9467 <br /> L-MRIC No Ext: <br /> DRESS: bhaovar@lestergrp.cam <br /> 1037 S.Main St. ADIL <br /> INSURER(S)AFFORDING COVERAGE NAIC N <br /> Burlington NC 27215 INSURER A: Beazley Insurance Company <br /> INSURED INSURER B: <br /> Happy Homecare Staffing Inc. INSURER C: <br /> 6720 Pentecost Rd. INSURER D: <br /> INSURER E: <br /> Cedar Grove NC 27231 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CL1952410117 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTER BELCW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE P01-1CY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VW2H THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFO ROE D BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUS10N5 AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ILTTRR TYPE OFINSURANCE AUUDLbUUK POLICYNUMSER MM7 DnYYY MWDDIYYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S <br /> DAMAGE R ENTED 7X SU,OOO <br /> CLAIMS-MADE OCCUR PREMISES Ea occurrence S <br /> MED EXP Any one arson) S 5,000 <br /> A V221BC190201 03/15/2019 03/15/2020 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LI M IT APPLIES PER: GENERALAGGREOATE $ 2,000,000 <br /> X POLICY JEa LOC PRODUCTS-COMPIOPAGG $ 2,000,000 <br /> OTHER: Professional Liability S 1,000.000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea amldent <br /> ANYAUTO BODILY INJURY(Par person) s <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOSONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> FAUTOS ONLY AUTOS ONLY Par acc dan! <br /> a <br /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE I $ <br /> DED I I RETENTION$ S <br /> WORKERS COMPENSATION PER OTIi- <br /> AND EMPLOYERS'LIABILITY Y 1 N STATUTE ER <br /> ANY PROPRIETORIPARTNERA-:XECUTIVE NIA E.L EACH ACCIDENT S <br /> OFFICE"EMBER EXCLUDED? <br /> (Mandatory in NH) E.L DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS 6etow E.L DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS 1 LCCA-nCNS 1 VEHICLES(ACCRO 101,Additional Remarks Schedule,may be attached it more space is rcqulmdl <br /> Includes Sexual Molestation$250,000 per Incldent and$750,000 Annual Aggregate. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANYOF 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 /> 113 Mayo Street <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> C 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />