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DocuSign Envelope ID:3972E6CB-2728-4F85-9405-C3827B138ABF <br /> ATE <br /> A�" CERTIFICATE OF LIABILITY INSURANCE D05/28/2021DIYYYv) <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 Enterprise Risk Financing&Insurance <br /> Marsh USA Inc. NAME: p 9 <br /> 333 South 7th Street,Suite 1400 AICNNo Ext: 952 936-1172 FAX No), <br /> Minneapolis,MN 55402-2400 E-MAIL .comuh <br /> Attn:Healthcare.AccountsCSS@marsh.com Fax:212-948-1307 ADDRESS: eis @ 9 <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> CN101631729-ALL-GAWUP-21-22 INSURER A:Old Republic Insurance Company 24147 <br /> INSURED INSURER B:N/A N/A <br /> LOGISTICS HEALTH,INC. <br /> 328 FRONT STREET SOUTH INSURER C:Travelers Property Casualty Company of America 25674 <br /> LACROSSE,WI 54601 INSURER D: <br /> INSURER E <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: CHI-009853058-01 REVISION NUMBER: 1 <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 INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> AMAGE TO TED <br /> A CLAIMS-MADE � OCCUR MWZY315405 05/01/2020 05/01/2022 PREM SES(Ea occurrence) $ 1,000,000 <br /> MED EXP(Any one person) $ 2,500 <br /> PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X POLICY❑ PRO- <br /> JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COEaMBINED accident SINGLE LIMIT $ 5,000,000 <br /> A X ANY AUTO MWTB315404 05/01/2020 05/01/2022 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 accident <br /> L $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> C WORKERS COMPENSATION UB-6R864629-21-NC-T(AOS) 05/01/2021 05/01/2022 X PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> C Y/N UB-6R80648A-21-NC-R(MA&WI) 05/0112021 05/01/2022 2,000,000 <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> C OFFICER/MEMBER EXCLUDED? N/'4 HWXJ-UB-472M4779-21 XWC OH 05/01/2021 05/01/2022 <br /> (Mandatory in NH) ( ) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 <br /> If yes,describe under (SIR$2M-XWC OH) E.L.DISEASE-POLICY LIMIT $ 2,000,000 <br /> DESCRIPTION OF OPERATIONS below <br /> A Managed Care Professional Liab MWZZ315406 05/01/2020 05/01/2022 Each Claim 10,000,000 <br /> Retro Date:1/1/77 Annual Aggregate 10,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> RE:STATE OF NORTH CAROLINA VACCINATION AGREEMENT/ADDITIONAL INSURED:ORANGE COUNTY GOVERMENT <br /> THE GENERAL LIABILITY POLICY INCLUDES A BLANKET ADDITIONAL INSURED ENDORSEMENT FOR PERSONS OR ORGANIZATIONS WHERE THE NAMED INSURED IS OBLIGATED TO PROVIDE <br /> SUCH STATUS BY WRITTEN CONTRACT OR AGREEMENT,ONLY TO THE MINIMUM EXTENT REQUIRED AND SUBJECT TO POLICY TERMS AND CONDITIONS. <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY GOVERNMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> ATTN:RISK MANAGER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ORANGE COUNTY,NC,PO BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> HILLSBOROUGH,NC 27281-8181 <br /> AUTHORIZED REPRESENTATIVE <br /> of Marsh USA Inc. <br /> Manashi Mukherjee _lVi av�ao .h1J�K L <br /> @ 1988-2016 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />