2015-316-E DSS - The Dispute Settlement Center, Inc. to assist the County in meeting goals of family safety and self-sufficiency to OC DSS clients $10,000

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DocuSign Envelope ID: 79C656D4-C9CC-4E83-86DC-2586ACE20052 gCoRD CERTIFICATE OF LIABILITY INSURANCE r6/3/2015 TE(MMfDDfYYYY) 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(ies)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 CONTACT Crystal Ireland NAME: BL1S1rie33 Insurers of Carolinas PHONE (919) 969-4611 MC No:(919)968-8991 800 Eastowne Drive, Suite 208 ADDRESS:cireland @business-insurers.com PO Box 2536 INSURER(S)AFFORDING COVERAGE NAIC# Chapel Hill NC 27515-2536 INSURER A:HairdIton Mutual Insurance Co 14125 INSURED INSURER B Em to ers Mutual Casualty 21415 DISPUTE SETTLEMENT CENTER INC INSURER C: 302 W WEAVER ST STE A INSURER D: INSURER E: CARRBOR0 NC 27510-6004 1 INSURER F COVERAGES CERTIFICATE NUMBER:CL156313007 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MWDOYIYEYYY MMf�OYIYYrr LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTED 300,000 A CLAIMS-MADE X OCCUR PREMISES 4Ea occurrence)$ 4W54487 6/17/2015 6/17/2016 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY PRO- LOG PRODUCTS-COMP/OP AGG $ 2,000,000 X OTHER: Hired/bonvwed $ 1,000,000 AUTOMOBILE LIABILITY COa MBINED SINGLE LIMIT $ E Oxidant ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOPJPARTNEP)EXECUTIVE ❑ NIA F.L.EACH ACCIDENT $ 100,000 OFFICERlMEMBER EXCLUDED? B (Mandatory In NH) 41154487 6/17/2015 6/17/2016 E.L.DISEASE-EA EMPLOYE $ 100 000 r yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 181,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION jetholnpson @orangecountync. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 S. Cameron Street ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE C Treland/TREL01 � ►tQ ©1988-2014ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025 ivowi)