2015-388-E Finance - Marian Cheek Jackson Center for Saving and Making History - 2015-16 Outside Agency Performance Agreement $8,000

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DocuSign Envelope ID: 5205F23F-E354-4606-942C-6C5F71600920 MARICHE OP ID: DR CERTIFICATE OF LIABILITY INSURANCE 1 D01/22120Y5 01f2212015 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 INSURERS), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION 1S 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 Phone: 919-682-4814 NAME: The Sorgi Insurance Agency r o41ve Lee Hammond FAX 16 Consultant Place Suite 102 Fax: 919-682-4906 Afc No Ex :919.682.4814 Arc Na; 919-682-4905 Durham,NC 27707 a-MAIL lee@sorglinsurance.com ADDRESS: James E.Sorg!,CIC _.__-v.__ .______. INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Erie Insurance Exchange 26271 INSURED Marian Cheek Jackson Center INSURER B;Westchostor Fire Insurance Co for Saving and Making History 512 West Rosemary St _iNSpRER C: Chapel Hill,NC 27510 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 EFF POLICY EXP LIMITS LTR POLICYNUMBER MhVDDNYYY MP,UDD[YYYY GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DPAAGE A X COMMERCIAL GENERAL LIABILITY X Q970503239 08/15/2014 08/15/2015 PREMISESa occurrence $ 1,000,000 CLARAS-MADE lxl OCCUR MEDEXP(Anyone_person) $ 5,000 PERSONAL&ADV INJURY $ x11000,000 GENERALAGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COP,IPIOPAGG $ 2,000,000 POLICY PRO- LOG - --_...-_._._.._ $_-___ AUT0490131LE LIABILITY CO?.4BINED SINGLE LIMIT 1000 X00 Ea accdent S A ANYAUTO 0370503239 0811512014 08115/2015 BODILY INJURY(Per person) S ALLOWNED SCHFDULFD AUTOS AUTOS BODILY INJURY(Peracddent) S X HIRED AUTO X NON-OWNED P" P, $ AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIh1S-A4ADE AGGREGATE $ OEO RETENTIONS $ WORKERS COMPENSATION X TORY LI V TAT OER AND EMPLOYERS'LIABILITY A ANY PROPRIETORlPARTNERlEXECUTIVEY�N Q921501020 0811512014 08115/2015 E,L,EACH ACCIDENT $ 500,000 OFFICEWMEMBFR EXCLUDED? NIA (htandatoryinNH) E.L-DISEASE-EAEMdPLOYE 5 500,000 if yes,describe under DESCRIPTION OF OPERATIONSbeiow E.L.DISEASE-POLICY LIMIT $ 500,000 B Professional Liab. G27096566001 19105!2014 1110512015 Prof Liab 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Orange County as additional, insured as respects to general liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Risk Manager THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y g ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD