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A�® CERTIFICATE OF LIABILITY INSURANCE D (MMIDD/YYYY) <br /> 06/27/2022 <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 Barbie Brown <br /> NAME: <br /> Sentinel Risk Advisors LLC paHtC N Ext): (919)926-4623 ac No): (919)926-4664 <br /> 4700 Six Forks Road E-MAIL bbrown@sentinelra.com <br /> ADDRESS: <br /> Suite 200 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Raleigh NC 27609 INSURERA: Hartford Underwriters Ins.Co. 30104 <br /> INSURED INSURER B: Accident Fund Insurance Cc 10166 <br /> Clean Design,Inc. INSURER C: <br /> 806 McCulloch Street, INSURER D: <br /> Suite 102, INSURER E: <br /> Raleigh NC 27603 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CL2232213559 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 INSURANCEADDLSUBR POLICY EFF POLICY EXP <br /> LTR INSD WVD POLICY NUMBER MM/DDIYYYY MM/DD/YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO CLAIMS-MADE FX OCCUR PREM SES Ea oNcuEr ante $ 1,000,000 <br /> MED EXP(Anv one person) $ 10,000 <br /> A 22SBAAK4H6B 03/26/2022 03/26/2023 -PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X JECT LOC PRODUCTS-COMP/OPAGG $POLICY ❑ PRO 2,000,000 <br /> OTHER: Employee Benefits $ 1,000,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED 22SBAAK4H6B 03/26/2022 03/26/2023 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 <br /> A EXCESS LIAB CLAIMS-MADE 22 SBAAK4H6B 03/26/2022 03/26/2023 AGGREGATE $ 2,000,000 <br /> DED I X RETENTION $ 10,000 $ <br /> WORKERS COMPENSATION X1 PER <br /> STATUTE EORH <br /> AND EMPLOYERS'LIABILITY YIN 1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> B OFFICER/MEMBER EXCLUDED? N NIA WCV6120677 06 01/01/2022 01/01/2023 <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 /> 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 BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P.O.Box 8181 <br /> AUTHORIZED REPRESENTATIVES <br /> Hillsborough NC 27278 4 <br /> ©19888-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />