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DocuSign Envelope ID:AA423ADA-1537-48C8-B878-6300C79ABB63 <br /> AC n ® DATE(MM/DD/WYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 08/05/2020 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br /> THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br /> AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN <br /> THE ISSUING INSURER(S),AUTHORIZED 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 <br /> endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an <br /> endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME:Trust Risk Management Services,Inc <br /> PHONE FAX <br /> Trust Risk Management Services,Inc.doing business in NC as Potomac A/C,No,Ext:877.637.9700 (A/c,No):877,251.5111 <br /> Risk Management Services, Inc. EMAIL <br /> 1791 Pas here Circle ADDRESS:info@trustrms.com <br /> y p INSURERS AFFORDING COVERAGE NAIC# <br /> Chicago,IL 60674 22667 <br /> INSURER A:ACE American Insurance Company <br /> INSURED INSURER B: <br /> Karin Yoch INSURER C: <br /> 3326 Durham Chapel Hill Blvd INSURER D: <br /> Bldg C,Suite 230 INSURER E: <br /> Durham, NC 27707 2600 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 <br /> PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT <br /> TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT <br /> TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADDL SUER POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDD/YYYY) (MM/DO/YYYY) LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGE TO RENTED $ <br /> CLAIMS MADE OCCUR PREMISES(Ea occurrence) <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> M'OTHER: <br /> L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> JECTPRO- PRODUCTS—COMP/OPAGGPOLICY PRO- LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per Person) $ <br /> ALL OWNED SCHEDULED $ <br /> AUTOS AUTOS BODILY INJURY(Per accident <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> Per accident <br /> OS <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ <br /> WORKERS COMPENSATION PER OTH- $ <br /> AND EMPLOYERS LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE❑ $ <br /> (Mandatory in NH) <br /> If yes,describe under $ <br /> E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS below <br /> Psychologist's Professional 88G22354991 06/01/2020 06/01/2021 Each Incident $1,000,000 <br /> A Liability Annual $3,000,000 <br /> Aggregate <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required): <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> Orange County Government DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough, NC,27275 AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />