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UI-F INbUHANUt tax:bluablu(h Apr 8 2010 01:15pm P001/001
<br />DocuSign Envelope ID: 2BA27576-F122-4D4E-840E-64070184E6A4 OP ID: SB
<br />JMM
<br />CERTIFICATE OF LIABILITY INSURANCE DATE - 04101'20 I 115 ,
<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 AMEN'D, EXTEND, OR ALTER THE COVERAGE AFFOROED ICY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( p, AUTHORIZED
<br />REPRESENTATIVE, OR PRODUCER, AND THE CERTIFICATE HOLDER,
<br />IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the p6licy{ias) must be andorsed. If $U13ROGATION IS WAIVED, sw0ject to
<br />the farrn& and conditions of the policy, certain policies may require an endorsement- A statement on this cartificata titres not Confer rights to the
<br />C,ertlfiOate: holder in lieu of such endorsement(s)-
<br />PRODUCER CONTACT
<br />Cn3t Fritschi & Paterson Inc PHONNAME-
<br />F- FAX
<br />ise 6rand Avenue, Suite 230 -WIC, No Ext! L=--, NLzt
<br />Oakland, 'A 94510 i=-MAJL
<br />-ADDRE
<br />FKQQUa;Vt
<br />CmRSMMFR anz 51OCIE-3
<br />INSURER(S)AFFORDING COVERAGE NAIC 0
<br />INSURED The Society For Phjlaqq!phta InqtmqtLIns Co.
<br />Creative Anachronism, Inc.
<br />INSURER B!
<br />P.O. Box 360789
<br />Milpitas, CA 9.5036. INSURER �C:
<br />INSURER 0:
<br />1145URER E;
<br />INSURER F!
<br />cnVFRAr.F.q f'1WT?TII7If'ATP MI HVIRII Dmisr-Inki kil ISAM00.
<br />TH15 15 TO CERTIFYTHAT THE POL111CILLS, OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED, NOTWTHSTANDNG ANY REOLAREMENT, TERM OR CONDITION I ANY CONTRACT OR OTHER
<br />DOCUMENT WITH RESPECT TO
<br />WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFrORDED BY THE POUOIES DESCRIBED
<br />HEREN I SUBJECT TO ALL
<br />THE TERMS,
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />TYPE OF NSUkANCC EFF �IPGLICYEXP—�
<br />=LTR11 IMA# wvr) POLICY NUMBER 11 -fyy) MMfDD[YYYY) I LIMITS
<br />2!NNERAL LIII
<br />'I'll, RRENCF
<br />� 991-OEOTO
<br />$ 1,000,mic
<br />X 7
<br />Co�
<br />A 22MMERCIAL GENERAL UANLITY
<br />KLN T ILL)
<br />�Ea O=U77`5-"�;
<br />100,0010
<br />-PREMISES
<br />MED EAP (A'Vor* wt&l)
<br />COO(
<br />PHPKII 270049 12131120:14 12131120116
<br />& AnV INJURY
<br />$ 1,000,00C
<br />_LERSC)NAL
<br />GENERALAC r RI
<br />$ 2,000,00C
<br />G&Pfl. AGGREGATF LIMIT APPLIES FIE R,
<br />$ 21000100(
<br />X7 Pou'Gy [�] PRO- El Loc
<br />AUTOMOBILE LIABIL17Y
<br />COMBINED SINGLE I-01T
<br />1,000,000
<br />A
<br />ANYAU70
<br />$
<br />8(4 i LY INJURY (Per oer�on)
<br />X ALLOW NFOAUTO
<br />$
<br />SCHEDULED AU70S
<br />PHIPIK127049 12J3112014
<br />1213112016
<br />500ILY INA�RY fP9r;)=d2rQ
<br />$
<br />PROPERTY DAMAGE
<br />HIRFID AUTO,$
<br />(PER ACCOIENT1
<br />NON-OWNED AUTOS
<br />$
<br />4
<br />UMBRELLA LIAS OCCUR
<br />I EACH OCCURRENCE
<br />s 10,()00,000
<br />A
<br />�'cEsS L'A'S CLAIMS-MADE
<br />PHUB483627
<br />1�?J3112014
<br />121,3112015
<br />AGGREGATE
<br />$ 10:,000,000
<br />1 :C7 E:
<br />'L
<br />tRETENT��:CN
<br />i
<br />I ............. .
<br />.
<br />EX
<br />$ 10,000
<br />. .
<br />WORKERS COMPENSA-RON
<br />WC STATL- CIETH,
<br />ANP FM1F11.QYFRZ'UA0ft4rY YIN
<br />5
<br />ANY
<br />F.L. EACH AC00FIJ
<br />OFFICER,WE BEREKQJZECr
<br />NIA
<br />IM amatory It NH)
<br />EASE , �EAEMPLOYEE
<br />S
<br />11 y", �Jqsv!;7* vr4,Rr
<br />E.L. DISEASE - POL1Ir-'Y LIN47
<br />Ti
<br />DESCRIPTION OF OFERATION5 I I„OCATQNS f VIGNICLE5 (AftachACORD lol Additional Remmrk3 SchadLAO, ifMore apaice is requIrea)
<br />RE- ORANGE COUNTY PUBLIC LIB Y", 137 WEST MARGARET LANE, HILLSBOROUGH, NC
<br />ON JUNE 6, 2015 10'00 A-M, TO 1,00
<br />20filliq
<br />ORANGE COUNTY PUBLIC LIBRARY
<br />137 WEST MARGARET LANE
<br />HILLSBOROUGH, NC 27278
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WTH THE POLICY PROVISIONS.
<br />AUT140RLZGD
<br />(71983.2005 AGORD CORPORATION. All nights reserved,
<br />ACORD 25 (2009109) The AGORD name and llogo are registered marks Of A001RD
<br />
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