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2013-352 Finance - Marian Cheek Jackson Center Outside Agency
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2013-352 Finance - Marian Cheek Jackson Center Outside Agency
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11/15/2013 4:27:44 PM
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11/15/2013 4:26:49 PM
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BOCC
Date
11/15/2013
Meeting Type
Work Session
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Agreement
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Mgr Signed
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R 2013-352 Finance - Marian Cheek Jackson Center Outside Agency
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2013
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MARICHE OP ID:DC <br /> CERTIFICATE OF LIABILITY INSURANCE DATE/29/2 V01 <br /> 08/29/23 <br /> 3 <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 be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER Phone:919-682-4814 NAME:ONTACT Debbie Callahan <br /> The Sorgi Insurance Agency Fax:919-682-4906 q"CNN Ed:919-682-4814 FAX,No):919 <br /> 16 Consultant Place Suite 102 E-MAIL <br /> Durham,NC 27707 ADDREss:debbie@sorgiinsurance.com <br /> James E.Sorgi,CIC <br /> INSURER(5)AFFORDING COVERAGE NAIC# <br /> INSURER A:Erie Insurance Exchange 26271 <br /> INSURED Marian Cheek Jackson Center INSURER B: <br /> for Saving and Making History INSURER C: <br /> 512 West Rosemary St <br /> Chapel Hill, NC 27510 INSURER D <br /> INSURER E: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: 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 INSURANCE ADDL SUB POLICY NUMBER MM/DDY� MMIDDIIYYYY LIMITS <br /> LTR <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY X Q970503239 08/15/2013 08/15/2014 REMIS O RENTED $ 1000,00 <br /> PREMISES Ea occurrence <br /> CLAIMS-MADE 1XI OCCUR MED EX P(Any one person) $ 5,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> POLICY PRO- LOC $ <br /> AUTOMOBILE LIABILITY (Ea accdentSINGLE LIMIT $ 1,0 00'00 <br /> A ANY AUTO Q970503239 08/15/2013 08/15/2014 BODILY INJURY(Per person) $ <br /> ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE <br /> X HIRED AUTOS X accident) <br /> $ <br /> AUTOS Per <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> D RETENTION$ $ <br /> WORKERS COMPENSATION X I WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY LIMITS I <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑N Q921501020 08/15/2013 08/15/2014 E.L.EACH ACCIDENT $ 100,00 <br /> OFFICER/MEMBER EXCLUDED? NIP` <br /> (Mandato in NH) E.L.DISEASE-EA EMPLOYEE $ 100,OU <br /> ry <br /> If yes,describe under 500,00 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Town of Chapel Hill and Orange County are named as additional insured in <br /> regard to General Liability. <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 /> Town of Chapel Hill and ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County <br /> 405 Martin Luther King Blvd AUTHORIZED REPRESENTATIVE <br /> Chapel Hill,NC 27514 <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD <br />
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