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DocuSign Envelope ID:5330770B-8F93-4746-9A9E-98B8628F995F <br /> 'bacu5ign Envelope ID:4B2345D6-005A-4A36-BAA2-26E7C59B79FA <br /> KAHCA•1 <br /> oA 0 106/2019 I <br /> CERTIFICATE OF LIABILITY INSURANCE o5lQ61z019 <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 pro0slons 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 rt hts to the certificate holder In lieu of such endorsements. <br /> PRODucER 82"96-33ilm <br /> McCroskey,CIC <br /> Granite Insurance Agency,Inc. "96-3342 No,826-396-3834S6 North Main StreetrOs ey@grdnitelnSUraRGe.COm <br /> Past Office Drawer 520Granite Falls,NC 28630-0620Tarry ARcCroskey,CIC INSU ER S AFFOR IND COVERAGE NAlCcident Fund insurance Co. 10166 <br /> rNet Insurance Company <br /> are LLC <br /> BARiphi at Home <br /> 4905 PfrTe Cone Drive,Suite 2 INsuRER o <br /> Durham,NC 27707 <br /> INSURER E <br /> INSU RER F <br /> COVERAGES CERTIFIC TE NUMBER: REVISION NUMBER` <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURER NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VNTH 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 PCUCY BFF POLICY E7CP <br /> TYPE OF INSURANCE UOL vn POLICY NUMBER LIMITS 1,000,DOO <br /> COMMERCIAL GENERAL LIAelury CH OCCURRENCE <br /> CLAIMS-WADE OCCUR HHS 0667980-12 o211612019 02/16/2020 D° AoeroRENreo 100,000 <br /> g )( Professional Limb HHS 8567989-12 02/1612019 0211612020 MEtO EXP n 8 arson 5,000 <br /> 1MEA13MAgg sONALB OVINJURY S1,000,00(] <br /> 3,000,000 <br /> NERALAGGRE 7E <br /> G N'LAa�RE LlMrrAPP ES PER: 3,000,000 <br /> POLICY 1 PR Lac R L1CT5- P+�7P AGG S <br /> OTHER:L� ECT iI���JJJ GDMBI ED SINGLE LIMk7 1,000,000 <br /> B AU70MOSILE LIABILITY <br /> ANYAUrO HHS 866798Q-12 02/16/2019 07116/2020 BODILYINJURY ■ arson <br /> x OWAfEs ONLY ACUp}u{RULED BODILY INJURY a a ddenl f <br /> AAAIuf'�fIREOD ONLY x ALUI7TT bfi 6aP�ER AGE <br /> UM5RELL A LIAR OCCUR EACH OCCURRENGe <br /> EXCESS LfAB CLAJMSAADE GGREGATE <br /> DED RETEtmoN S LmiPER OTH- <br /> A WORKERS <br /> sArOhl <br /> MP� SAO LIABILITY <br /> N CV6198250 06105/2019 06105/2020 EL EAc ACCIM211 1,000,000 <br /> ANY _ KEECunVE xlA 1,000,000 <br /> 9nnC P W,E a <br /> ❑!S€ASE-E;4 EMPLOY S <br /> If eLLs dassrl6aundEr E. ❑ISEASE-PGLJCYUM 1,000,000 <br /> D IPTION OF OPERA S balow 50 Q00 <br /> B CrimelEmp Theft HHS B667980-12 02 I612019 02/16/2020 Crime/Emp <br /> 9 AbuselMDlestation HHS 8667980.12 02/1612019 02/16/2020 AbuselMot 1,000,000 <br /> DESCRIP-11 ON OF OPERAPONS 1 LO cAT1 ONS I VEHICLES{ACORO 101,Ad dRle nai Remarks Sohedule,mey be ilt—hed if more 39%ae Is requlrodl <br /> CERTIFICATE HOLDER C CELLA <br /> TION <br /> ORANG-1 <br /> SHOULD ANY OF THE ABOVE DES CRIBED POL[CIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County Department of <br /> Social.Services AUTHORIZED REPRESENTATIVE <br /> PO BOX 8181 <br /> Hillsborough,NC 27278 p�tcn••04J• L f <br /> (UJ <br /> ACORD 25{I 2016103i ©1986-2015 AGORA CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORO <br />