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2015-329-E Aging - Martha Broda for wellness instructor $2,000
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2015-329-E Aging - Martha Broda for wellness instructor $2,000
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6/2/2016 2:54:04 PM
Creation date
7/10/2015 10:04:54 AM
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BOCC
Date
7/9/2015
Meeting Type
Work Session
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Contract
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R 2015-329-E Aging - Martha Broda for wellness instructor
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2015
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DocuSign Envelope ID:66806383-C635-48A3-B408-7BC6C50D832B <br /> DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 07/07/2014 <br /> PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION <br /> Maguire Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 27101 <br /> ission ertaRealSuite200 HOLDER. THIS CERTIFICATE DOES NOT AMMEND, EXTEND OR <br /> Mission CA 92691- ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 877.438.7459 <br /> INSURERS AFFORDING COVERAGE NAIL# <br /> INSURED INSURER A:Philadelphia Indemnity Insurance Company 18058 <br /> Martha Broda INSURER B: <br /> 1388 Manns Chapel Rd <br /> Pittsboro,NC 27312- INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERIFICATION MAY BE ISSUED OR <br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADD'L I POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YYYY) DATE(MM/DD/YYYY) LIMITS <br /> A X GENERAL LIABILITY PHPK1071271- 08/0512014 08/05/2015 EACH OCCURENCE $1,000,000 <br /> AMAGE TO RENTED <br /> X COMMERCIAL GENERAL LIABILITY 001 PREMISES Ea occurrence $100,000 <br /> CLAIMS MADE ❑X OCCUR MED EXP(Any one person) $2,500 <br /> X PROFESSIONAL LIABILITY PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $3,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS—COMP/OP AGG $3,000,000 <br /> X POLICY PROJECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANYAUTO (EA accident) <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS BODILY INJURY <br /> NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY—EA ACCIDENT <br /> ANY AUTO OTHERTHAN EAACC <br /> AUTO ONLY: AGG <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURENCE <br /> OCCUR F—] CLAIMS MADE AGGREGATE <br /> DEDUCTIBLE <br /> RETENTION <br /> COMPENSATION C A - - <br /> EMPLOYERS'LIABILITY Y N TORYLIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? E.L.EACH ACCIDENT <br /> (Mandatory in NH) E.L.DISEASE—EA AMPLOYEE <br /> Ifyes describeunder <br /> SPECIAL PROVISIONS below - E.L.DISEASE—POLICY LIMIT <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATION$/VEHICLES/EXCLUSIONS ADDED 13Y ENDORSEMENT/SPECIAL PROVISIONS <br /> It is understood and agreed that the following entity is added as an additional insured but only with respect(s)to the operations of the named insured except that liability resulting from the additional insured's sole <br /> negligence. <br /> I <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE <br /> THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE <br /> CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR <br /> LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE kE <br /> k' <br /> ACORD 25(2009/01) © 1988-2009 ACORD CORPORATION.All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> i <br /> i <br />
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