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DocuSign Envelope ID:9B17AE47-7170-4AB0-9270-E4000CD67956
<br /> DATE(MM/DD/YYYY)
<br /> A�" CERTIFICATE OF LIABILITY INSURANCE
<br /> 05/26/2023
<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 aCC Ext: (919)926-4623 a XC,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 Company ofAmerica 10166
<br /> Clean Design,Inc. INSURER C: United States Liability Ins.Co. 25895
<br /> 806 McCulloch Street, INSURER D:
<br /> Suite 102, INSURER E:
<br /> Raleigh NC 27603 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: CL234515797 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/DD/YYYY MM/DD/YYYY LIMITS
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO_7CLAIMS-MADE �X OCCUR PREM SES Ea oNcRETE ante $ 1,000,000
<br /> MED EXP(Anv one person) $ 10,000
<br /> A Y 22 SBAAK4H6B 03/26/2023 03/26/2024 PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN-LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> JECT LOC PRODUCTS-COMPOPAGG $POLICY ❑ PRO 2,000,000P1
<br /> OTHER: Employee Benefits $ 1,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> ANYAUTO BODILY INJURY(Per person) $
<br /> A OWNED SCHEDULED 22 SBAAK4H6B 03/26/2023 03/26/2024 BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED �/ NON-OWNED PROPE DAMAGE $
<br /> AUTOS ONLY /� AUTOS ONLY Per accidentRTY
<br /> X UMBRELLA LIAB M
<br /> OCCUR EACH OCCURRENCE $ 2,000,000
<br /> A EXCESS LIAB CLAIMS-MADE 22 SBAAK4H6B 03/26/2023 03/26/2024 AGGREGATE $ 2,000,000
<br /> DED I X1 RETENTION $ 10,000 $
<br /> WORKERS COMPENSATION X1 STER ATUTE EORH
<br /> AND EMPLOYERS'LIABILITY Y/N 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
<br /> B OFFICER/MEMBEREXCLUDED? NIA AFWCP100081801 01/01/2023 01/01/2024
<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 /> Professional Liability Occurence Limit $2,000,000
<br /> C SP 1559388H 03/26/2023 03/26/2024 Aggregate Limit $2,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Orange County,its officers,agent and employees are included as an Additional Insured on General Liability Coverage per written contract.
<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 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 300 West Tryon Street
<br /> AUTHORIZED REPRESENTATIVE
<br /> PO Box 8181
<br /> Hillsborough NC 27278
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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