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Date(MMIDDIYYYY) <br /> Certificate Of Insurance Issue 08/21/2013 <br /> Named Participant This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. <br /> Town of Chapel Hill This Certificate does not amend,extend or altar the coverage afforded by the Policies below <br /> 405 Martin Luther King Jr.Blvd Com panies affording Coverage <br /> Chapel Hill,NO 27514 A= Interlocal Risk Financing Fund of North Carolina <br /> B= North Carolina Interlocal Risk Management Agency <br /> COVERAGES <br /> THIS IS TO CERTIFY THAT THE COVERAGE LISTED BELOW IS AFFORDED TO THE PARTICIPANT NAMED ABOVE FOR THE PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY <br /> CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE COVERAGE DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS <br /> OFSUCHPROGRAM. <br /> Co Type of Coverage Policy Number Effective Expiration Limits of Liability <br /> Lo- Date Date <br /> GENERAL LIABILITY Products-Comp/Operations <br /> ❑Commercial General Liability Personal&Adv.Injury <br /> ❑Claims Made ❑Occurrence Each Occurrence <br /> Fire Damage(Any one fire) <br /> Med.Expense(Any one person) N/A <br /> Deductible <br /> AUTOMOBILE LIABILITY Limit Deductible <br /> ❑Any Auto(Symbol 1) Combined Single Limit <br /> ❑ Hired Autos(Symbol 8) <br /> ❑ <br /> Non-Owned Autos(Symbol 9) <br /> ❑Uninsured/Underinsured Motorists <br /> PROPERTY Limit Deductible <br /> ❑Real&Personal Property <br /> ❑Builder's Risk <br /> ❑Auto Physical Damage(Symbol 7&8) <br /> ❑Municipal Equipment <br /> ❑Computer Equipment&Media <br /> ❑Portable Equipment <br /> ❑Fine Arts <br /> Police Professional Liability Limit(per occurrenoe/aggregate) Deductible <br /> ❑Claims Made ❑Occurrence <br /> Public Officials Liability Limit(per occurrence/aggregate) Deductible <br /> ❑Claims Made ❑Occurrence <br /> Employment Practices Liability Limit(per occurrence/aggregate) Deductible <br /> ❑Claims Made ❑Occurrence FT <br /> A Workers'Compensation WC-12-2013-00 07/01/2013 07/01/2014 Limit <br /> ❑x Workers'Compensation and Employers Liability Each Accident $1000,000 <br /> ❑x WC Statutory Limit Disease-Each Employee s1.000,000 <br /> Disease-Policy Limit $1•00°•00° <br /> OTHER COVERAGE Limit Deductible <br /> Description <br /> Evidence of coverage <br /> Certificate Holder Cancellation <br /> Orange County Should any of the above described coverages be cancelled before <br /> 200 S.Cameron St. the expiration date thereof the issuing company will endeavor to <br /> Hillsborough,NC 27278 mail 30 days written notice to the certificate holder named to the left, <br /> but failure to mail such notice shall impose no obligation or liability <br /> of any kind upon the company,its agents or representatives. <br /> Autho' d Representative <br />