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DocuSign Envelope ID:6D93A671-B4B5-4AC8-9EAC-8F9F070B5EDA
<br /> ARCOF-4 OP ID: KB
<br /> ,a►coR® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> � 07/08/2015
<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 Kendra A Biddle, CPCU, CIC
<br /> 440 South Church St.,Ste 500 WC,No Ext:336-899-2410 FAX No): 336-841-5319
<br /> Charlotte, NC 28202 E-MAIL kbiddle @senndunn.com
<br /> M.Bryan Beasley,CIC ADDRESS:
<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 INSURER C:
<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 /> INSR TYPE OF INSURANCE DDL UBR POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
<br /> B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA AG CLAIMS-MADE OCCUR CPA4256553 07/01/2015 07/01/2016 PREM SES(Ea oocurrDence $ 1,000,000
<br /> MED EXP(Any one person) $ 20,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> POLICY PRO-
<br /> JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 3,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> Ea accident
<br /> B ANY AUTO CPA4256553 07/01/2015 07101/2016 BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS _ AUTOS
<br /> X X NON-OWNED PROPERTY DAMAGE $
<br /> HIRED AUTOS AUTOS Per accident
<br /> X UMBRELLA LAB X OCCUR EACH OCCURRENCE $ 1,000,000
<br /> B EXCESS LIAB CLAIMS-MADE CPA4256553 07/01/2015 07/01/2016 AGGREGATE $ 1,000,000
<br /> DED X I RETENTION$ 0 $
<br /> WORKERS COMPENSATION X PER 0TH-
<br /> AND EMPLOYERS'LIABILITY STATUTE I ER
<br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 03-0000038729-07 07/04/2015 07/04/2016 E.L.EACH ACCIDENT $ 500,000
<br /> OFFICER/MEMBER EXCLUDED? ❑N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I $ 500,000
<br /> B Professional CPA4256553 07/0112015 07/01/2016 Incident 1,000,000
<br /> Liability Aggregate 3,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached 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, INC 27278 1 ��
<br /> y� ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br />
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