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ARCOF-4 OP ID: KB
<br /> CERTIFICATE OF LIABILITY INSURANCE
<br /> DATE 06/04/2015Y)
<br /> 06/04/2015
<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 CONTACT
<br /> Senn Dunn-Charlotte NAME: Kendra A Biddle,CPCU, CIC
<br /> 440 South Church St.,Ste 500 A/c°No Et l:336-899-2410 (FAX,No): 336-841-5319
<br /> Charlotte,NC 28202 E-MAIL
<br /> M.Bryan Beasley,CIC ADDRESS:kbiddle@senndunn.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Eastern Alliance Insurance Co. 10724
<br /> INSURED The Arc of the Triangle INSURER B:Firemans Ins of Washington DC 21784
<br /> 208 N. Columbia St.,Suite 100
<br /> Chapel Hill, NC 27514 INSURERC:
<br /> 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 /> rB TYPE OF INSURANCE L POLICY NUMBER MM DID/YYYY MM/D/YYYY LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
<br /> X COMMERCIAL GENERAL LIABILITY CPA4256553 07/01/2014 07/01/2015 PREMISES Ea occurrence $ 1,000,00
<br /> CLAIMS-MADE I OCCUR MED EXP(Any one person) $ 20,00
<br /> PERSONAL&ADV INJURY $ 1,000,00
<br /> GENERAL AGGREGATE $ 3,000,00
<br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OPAGG $ 3,000,00
<br /> POLICY PRO LOC $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00
<br /> Ea accident $_
<br /> B ANY AUTO CPA4256553 07/01/2014 07/01/2015 BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> X HIRED AUTOS X ACCID
<br /> NON-OWNED PER DNMAGE $
<br /> AUTOS
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00
<br /> B EXCESS LIAB CLAIMS-MADE CPA4256553 07/0112014 07/01/2015 AGGREGATE $ 1,000,00
<br /> DIED I X I RETENTION$ 0 $
<br /> WORKERS COMPENSATION WC STATU- OTH-
<br /> AND EMPLOYERS'LIABILITY X TORY LIMITS
<br /> ER
<br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 03-0000038729-06 07/04/2014 07/04/2015 E.L.EACH ACCIDENT $ 500,00
<br /> OFFICER/MEMBER EXCLUDED? ❑ N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ 500,00
<br /> B Professional CPA4256553 07/01/2014 07/01/2015 Incident 1,000,00
<br /> Liability T Aggregate 3,000,00
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANG18
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 200 S Cameron Street
<br /> P O Box 8181 AUTHORIZED REPRESENTATIVE
<br /> Hillsborough, NC 27278 }�1 ) Qe--�
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