2015-395-E Finance - Orange County Rape Crisis Center - 2015-16 Outside Agency Performance Agreement $30,000

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DocuSign Envelope ID:80D157E5-4FlA-4810-B2B8-EE640BAE05B1 OP ID: NE CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/10/2015 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 High&Rubish Insurance Agency aI oNE FAX P.O.Box 3040 A/C No Ext: A/C,No): 6015 Farrington Rd.Ste 101 E-MAIL Chapel Hill,NC 27517 ADDRESS: Jeffrey A.Rubish PRODUCER ORANG-2 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC# INSURED Orange Cty Rape Crisis Center INSURER A:Philadelphia Insurance Co 1506 E.Franklin St,Ste 302 INSURER Chapel Hill, NC 27514 suRERe:Hartford Insurance Company INSURER C: 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. ILTR TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY/ INYYY MM/POLICY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X PHPK1080626 10/10/2014 10/1012015 DAMAGE T RENTED 100 000 PREMISES Ea occurrence $ CLAIMS-MADE ® OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 X prof liab-$2 mill GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY A X HIRED AUTOS (PER ACC DENT) $ X NON-OWNED AUTOS PHPK1080626 10/1012014 10/1012015 $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY ORY LIMITS ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N T 22WBCNY9475 04/24/2015 04/24/2016 E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDE[? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Directors&Office PHSD1046424 06/30/2015 06/30/2016 D&O 1,000,000 B Dishonesty Bond 22BPEEA2664 06/0312015 06/03/2016 Bond 300,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Additional Insured: Ora a Count (Professional Liability limits are $1,000,000 occurrence/ ,000,00&faggregate) CERTIFICATE HOLDER CANCELLATION ORANG-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ORANGE COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Risk Manager ACCORDANCE WITH THE POLICY PROVISIONS. P O Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE a%_LLQ ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD