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DocuSign Envelope ID:8C9741F7-7393-4B78-9DF3-BFBF6EBAAB53
<br /> A ��0 CERTIFICATE OF LIABILITY INSURANCE DATE(M 04/02//2020 Y)
<br /> 020
<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 CONTACT Doug Farber
<br /> NAME:
<br /> Insurance Management Consultants,Inc. PAHi�Nri Ext: (704)799-1600 C,No): (704)799-2955
<br /> P.O.Box 2490 E-MAIL cert@imcipls.com
<br /> ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Davidson NC 28036 INSURERA: RLI Insurance Company 13056
<br /> INSURED INSURER B:
<br /> Boomerang Design,P.A. INSURER C:
<br /> 201 S.Washington Street INSURER D:
<br /> Suite 200 INSURER E:
<br /> Shelby NC 28150 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 19/20All Lines Renewal 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 /> TR INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE To_7CLAIMS-MADE � OCCUR PREM SES Ea occurrence)l
<br /> $ 1,000,000
<br /> MED EXP(Any one person) $ 10,000
<br /> A Y PSB0008233 10/31/2019 10/31/2020 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> JECT
<br /> OTHER: Employee Benefits $ 1,000,000
<br /> AUTOMOBILE LIABILITY G®M91NED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> X ANYAUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED PSA0002706 10/31/2019 10/31/2020 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED �/ NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY /� AUTOS ONLY (Per accident)
<br /> Medical payments $ 1,000
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000
<br /> A EXCESS LIAB CLAIMS-MADE PSE0004074 10/31/2019 10/31/2020 AGGREGATE $ 3,000,000
<br /> DED I I RETENTION $ $
<br /> WORKERS COMPENSATION X SPERTATUTE EORH
<br /> AND EMPLOYERS'LIABILITY Y/N 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> A OFFICER/MEMBER EXCLUDED? NIA PSW0001649 10/31/2019 10/31/2020
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> Per Claim $1,000,000
<br /> A Professional Liability RDP0037861 10/31/2019 10/31/2020 Aggregate $1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> If required by written contract,Orange County is additional insured for general liability.
<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 County ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> PO Box 8181
<br /> AUTHORIZED REPRESENTATIVE
<br /> Hillsborough NC 27278
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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