2012-421 DEAPR - Farmer Foodshare Inc for User Services

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AC40RV DATE(MMIDOMM il%.� CERTIFICATE OF LIABILITY'ILITY INSURANCE F12/3/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER Co MV T CT Jeff D INA arling Cooley and Darling Insurance Agency PHONE (703)881-0113 FAX (Ag No Fift A, No):(703)659-0024 PO Box 1228 ADDR E-MAIL ESS:jdarling@cd-insure.com INSURERS)AFFORDING COVERAGE NAIC# Haymarket VA 20168 INSURER A'Alliance of Nonprofits 10023 INSURED INSURER B: Farmer Foodshare, Inc. INSURER C: 104 Granite Ridge Road INSURER D: INSURER E: lChapel Hill NC 27516 INSURER F: COVERAGES CERTIFICATE NUMBER CL1212303064 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. r INSR ADDLSU POLICY SR POCYEFF POIUCYEXP T LT TYPE OF INSURANCE POLICY NUMBER (MMMIDArfM (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE T RENTED O X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 50,000 A A CLAIMS-MADE Fx]OCCUR X 2012-34971 12/1/2012 12/1/2013 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X1 POLICY F1 SECT F-1 LOC $ AUTOMOBILE LIABILITY (E COMBINE.id . w D,)SINGLE,LIMIT . $ 1,000,00 A ANY AUTO BODILY INJURY(Per Person) $ ALL OWNED SCHEDULED 2012-34971 12/1/2012 12/1/2013 BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS N AUTOS Per accident) UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LAS HCLAIMS-MADE I AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION )TH- AND EMPLOYERSIUABIUTY YIN ER ANY PROPRIETOR/PARTNER/EXECUTIVE r--j E,L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF,OPERATIONS below E.L.DISEASE-POLICY LIMIT $ IE1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Certificate holder is included as additional insured as their interests may appear, but only with respect to claims arising out of the operations of the named insured and only per the terms, conditions and exclusions of the policies as issued. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County, NC and ACCORDANCE WITH THE POLICY PROVISIONS. Piedmont Food and Agricultural Processing AUTHORIZED REPRESENTATIVE Center . Jeff Darling/JEFF ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INSn25(qninnsi ni Thg%Annnn names and loweew are wanieforawi marlea of Annizin