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2015-384-E Finance - A Helping Hand - 2015-16 Outside Agency Performance Agreement $2,000
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2015-384-E Finance - A Helping Hand - 2015-16 Outside Agency Performance Agreement $2,000
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8/3/2015 3:20:45 PM
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8/3/2015
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Agreement
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R 2015-384-E Finance - A Helping Hand - 2015-16 Outside Agency Performance Agreement
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2015
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DocuSign Envelope ID: E19FOB55-C788-42EE-B1CD-2C724D1698F4 <br /> OP ID: NE TE(M MID <br /> CERTIFICATE OF LIABILITY INSURANCE 707/20/201D/YYYY) <br /> 5 <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 /> High&Rubish Insurance Agency PHONE FAX <br /> P.O.Box 3040 A/C No Ext: A/C No' <br /> 6015 Farrington Rd.Ste 101 E-MAIL <br /> Chapel Hill,NC 27517 ADDRESS: <br /> Jeffrey A.Rubish PRODUCER HELPI-1 <br /> CUSTOMER ID#: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED A Helping Hand INSURER A:Cincinnati Insurance Companies 10677 <br /> 1502 W Hwy 54 Ste 405 INSURER B:U.S. Liability Insurance Co. <br /> Durham, NC 27707 <br /> 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 <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY HHC000588 03/01/2015 03101/2016 DAMAGE TO RENTED 100 000 <br /> PREMISES Ea occurrence $ <br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> POLICY PRO EC F LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) $ 1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS BODILY INJURY(Per accident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> A X HIRED AUTOS HHC000588 03101/2015 03/01/2016 (PER ACCIDENT) $ <br /> X NON-OWNED AUTOS $ <br /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS C O M P E N S A T I O N W C STATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y I N TORY LIMITS ER <br /> ANY PROP RIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? [::] N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> B Professional Liab ND010541771 0910912014 0910912015 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANG-3 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 South Cameron Street <br /> P.O. Box 8181 <br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD <br />
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