Orange County NC Website
Browse       Search
DocuSign Envelope ID:8953AD6C-C803-4BE3-B456-79DFD2637F3E <br /> ACC DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 07/04/2021 <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.If <br /> SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this LD <br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT a <br /> NAME: <br /> Aon Risk Services central, Inc. PHONE (866) 283-7122 FAX (800) 363-0105 `y <br /> Philadelphia PA office INC.No.Ext): A/c.No.: a <br /> one Liberty Place E-MAIL e <br /> 1650 Market Street ADDRESS: _ <br /> Suite 1000 <br /> Philadelphia PA 19103 USA INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: Indian Harbor Insurance Company 36940 <br /> Res-Care, Inc. INSURERB: ACE American insurance company 22667 <br /> 805 North Whittington Parkway STE 400 <br /> Louisville KY 40222 USA INSURERC: Indemnity Insurance Co of North America 43575 <br /> INSURERD: Endurance American insurance Company 10641 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:570088340601 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. Limits shown are as requested <br /> INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MWDD YYY MM/DD YYY POLICY EXP LIMITS <br /> B X COMMERCIAL GENERAL LIABILITY XSLG7248079A 1120Z2 EACH OCCURRENCE $4,000,000 <br /> X CLAIMS-MADE ❑OCCUR EXCeSS GL/Prof-Claims Md DAMAGE TO RENTED $4,000,000 <br /> SIR applies per policy terns & condi ions PREMISES Ea occurrence <br /> X Professional Liability Included MED EXP(Any one person) $10,000 <br /> X Sexual Abuse/Moleslatlon Included PERSONAL&ADV INJURY $4,000,000 0 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $6,000,000 a <br /> X POLICY ❑PRO LOC PRODUCTS-COMP/OPAGG $4,000,000 o <br /> 0 <br /> 00 <br /> OTHER: <br /> B 11 07/01/20210710112022 COMBINED SINGLE LIMIT <br /> AUTOMOBILE LIABILITY ISA H255487 $2,000,000 <br /> E accident) „ <br /> X ANYAUTO BODILY INJURY(Per person) C <br /> Z <br /> OWNED SCHEDULED BODILY INJURY(Per accident) 4) <br /> AUTOS ONLY AUTOS <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE V <br /> ONLY AUTOS ONLY Per accident <br /> 1: <br /> 01 <br /> D UMBRELLA LIAR X OCCUR XSc30000119105 07/01/2021 07/01/2022 EACH OCCURRENCE $3,000,000 U <br /> X EXCESS LIAB CLAIMS-MADE XS Auto & EL Only AGGREGATE $3,000,000 <br /> DED RETENTION <br /> C WORKERS COMPENSATION AND WLRC67822705 07/01/2021 07/01/2022 X I PER STATUTE I OTH- <br /> EMPLOYERS'LIABILITY Y/N ADS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $2,000,000 <br /> B OFFICERIMEMBEREXCLUDED? Y N/A WLRC67822663 07/01/2021 07/01/2022 <br /> (Mandatory In NH) CA E.L.DISEASE-EA EMPLOYEE $2,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $2,000,000- <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) ��.. <br /> Retroactive Date for Policy #XSLG7248079A is 7/1/01. CNC/Access, Inc. dba All Ways caring Homecare a subsidiary of Rescare, <br /> Inc. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br /> POLICY PROVISIONS. ■ice.■ <br /> orange County AUTHORIZED REPRESENTATIVE <br /> 113 Mayo St. <br /> Hillsborough NC 27278 USA <br /> �. c.�:kYfG r5�i!84EIEd �hsfBGE�f �,idEl <br /> ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />