2015-411-E Finance - Housing for New Hope - 2015-16 Outside Agency Performance Agreement $22,000

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DocuSign Envelope ID: 3865CB70-868B-4199-92CE-5DB7C6DE1903 OP ID:CH CERTIFICATE OF LIABILITY INSURANCE DATE 0710812015Y) 07/08/2015 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 First Insurance Services,Inc. NAME: P.O.Box 13687 A No Ext: A/C No): RTP,NC 27709 E-MAIL Cathy N.Hall ADDRESS: PRODUCER HOUSI-2 CUSTOMER ID#: INSURER(S)AFFORDING COVERAGE NAIC q INSURED Housing For New Hope Inc INSURER A:Hartford Casualty Insurance Co 29424 18 West Colony Place#250 Durham,NC 27705 INSURER B:Twin City Fire Insurance Co. 29459 INSURER C:Western World 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 TR TYPE OF INSURANCE ODL UBR POLICY NUMBER MM/DDY/YYYY MM/DDY� LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 C X COMMERCIAL GENERAL LIABILITY X NPP1051286 10/22/2014 10/22/2015 PREMISES Ea occurrence $ 50,000 CLAIMS-MADE FK OCCUR MED EXP(Any one person) $ 5,00 X PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 3,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,00 POLICY PRO- JER L1 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) B ANY AUTO 22ZAFNA0507 1213012014 12/30/2015 BODILY INJURY(Per person) $ 100,00 ALL OWNED AUTOS BODILY INJURY(Per accident) $ 300,00 X SCHEDULEDAUTOS PROPERTY DAMAGE $ 50,000 X HIREDAUTOS (PER ACCIDENT) X NON-OWNED AUTOS $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,00 C 3272358150 10/2212014 10/22/2015 DEDUCTIBLE Excess $ RETENTION $ Following $ WORKERS COMPENSATION M STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N XXXXXXXXXX E.L.EACH ACCIDENT $ XXXX OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ XXXXXX If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ XXXXXX C Professional NPP1051286 10/22/2014 10/22/2015 Incident 1,000,00 Occurrence Form Gen Aggr 31000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) Orange County is hereby listed as additional insured if required by a written contract or agreement prior to a loss. CERTIFICATE HOLDER CANCELLATION ORANGE2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, Orange County Finance ACCORDANCE WITH THE POLICY PROVISIONS.NOTICE WILL BE DELIVERED IN &Administrative Services 200 South Cameron St Box 8181 Hillsborough,NC.27278 AUTHORIZED REPRESENTATIVE C__�n 7-1. -1,--P 2 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD