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DocuSign Envelope ID:D76EOBB3-1E71-4C6C-B396-A64E9777B70E <br /> A�� ® DATE(MMIDDIYYYY) <br /> l`�+ViR" CERTIFICATE OF LIABILITY INSURANCE 8/14/2020 <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 <br /> NAME: Christina Luckey,CISR,CLCS <br /> Marsh&McLennan Agency LLC PHONE FAX <br /> 5605 Carnegie Blvd. (A/C.No Ext:704-556-3329 A/c No):212-607-6514 <br /> Suite 300 ADDRESS: christina.luckeyamarshmma.rom <br /> Charlotte NC 28209 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Alliance of Nonprofits forinsurance RRG 10023 <br /> INSURED HAVEN-2 INSURER B: Eastern Alliance Insurance Company 10724 <br /> Haven House, Inc. <br /> Juli Kirby INSURER C: <br /> 600 W Cabarrus Street INSURER D: <br /> Raleigh NC 27603 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1687872021 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 /> INSR TYPE OF INSURANCE ADDL SUBR . POLICY EFF POLICY EXP LIMITS <br /> LTR p POLICY NUMBER MM/DD MMIDD <br /> A X COMMERCIAL GENERAL LIABILITY 202025015 2/1/2020 211/2021 EACH OCCURRENCE $1,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMISES Ea occurrence1 $500,000 <br /> MED EXP(Any one person) $20,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 <br /> JECT <br /> POLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $3,000,000 <br /> X <br /> OTHER: Liquor Liability $*SEE BELOW <br /> A AUTOMOBILE LIABILITY 202025015 2/1/2020 2/1/2021 COMBINED SINGLE LIMIT $1,000,000 <br /> Ea accident <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accid <br /> entt <br /> $ <br /> A X UMBRELLA LIAB X OCCUR 201925015UMB 2/1/2020 2/1/2021 EACH OCCURRENCE $2,000,000 <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $2,000,000 <br /> DIED I X I RETENTION$in nnn $ <br /> B WORKERS COMPENSATION 030000050295 2/1/2020 2/1/2021 XPER <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ERH <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $500,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 <br /> A Professional Liability 202025015 2/1/2020 211/2021 LIMIT/DED **SEE BELOW <br /> Sexual Conduct/Abuse Liability LIMIT/DED ***SEE BELOW <br /> Employee Benefits Liability LIMITIDED ****SEE BELOW <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space is required) . <br /> *LIQUOR LIABILITY--- <br /> Generai Aggregate Limit$1,000,000 <br /> Each Common Cause Limit$1,000,000 <br /> **PROFESSIONAL LIABILITY-- <br /> Aggregate Limit$3,000,000 <br /> Each Event Limit$1,000,000 <br /> See Attached... <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 Goverment ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attn: Risk Manager <br /> PO Box 8181 AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27287 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />