2015-420-E Finance - Big Brothers Big Sisters of the Triangle, Inc. - 2015-16 Outside Agency Performance Agreement $2,000

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DocuSign Envelope ID: 56F58E6E-B4D7-4C 1 5-A41 B-1 1760E69E95E BIGBR-1 OP ID:DC A�°�°' CERTIFICATE OF LIABILITY INSURANCE °07`1412015' 0711412015 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(les) 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 hoiderin lieu of such endorsement(s). PRODUCER CONTACT Moore & Johnson Agency PHONE FAx PO Box 17867 C No Ext: C No Raleigh, INC 27619 ADDRESS: Edwin L.Walker INSURER(S)AFFORDING COVERAGE NAIC I INSURERA:Employers Insurance Company 44SURED Big Brothers Big Sisters of INSURER B:Granite State Insurance Co the Triangle INSURERC:United States Liability Ins Attn: Kim Breeden 808 Aviation Parkway,Ste 900 INSURERD: Morrisville,NC 27560 INSURERS: 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 LTR TYPE OF INSURANCE POLICYNUMBER IMPIONICOM tMINDONY" LIMns GENERAL LIABILITY FBI.{OCCURRENCE g 11000,00 B X COQ^„ERCIAL GENERAL LIABILITY 02LX0158496646000 09/2812014 0912812015 PREMISES I Ea occurrence g 230,000 a1u!,( MAMA E XI OCCUR VED F'V(Arry om Person) 5 10,000 PERSON'q s ADV INJIURY $ 1,000,00 C D&O$1,000,000 ND01067489D 0912812014 0912812015 GENERAL AGGREGATE $ 3,000,00 G>NtAGGfzEGATELIMITPFPLIESPER' PRODUCTS-COw"'A.GG 1 3,000,00 PWCY PRO EX-1 LOC Emp Ben. 1,000,00 AUrOMOBILE LIABILITY COWINED SINGLE LI%Iff 1,000,00( (Ea axiderd) $ B ANY AUTO 02CA0158474746000 09/2812014 0912812015 BODILY INJU2Y(Pefpersonj $ ALL OW EO SCHEDULLD BODILY INJURY(Pti accident) $ AUTOS OWNED PROPERTY DN4Ar�E $ X HIREDFUTOS X AIJTOS (PERACCIDENT) UMSRELLALUIB OCCUR EACH OCCUFVENCE $ EXCESSLIAB CLAI!!S-P,VDE AGGREGATE $ DED I I REfEmnoo s $ WORKERS COMPENSATION X WC STATU- W AND EMPLOYERS'LlABILrTY TORY LIl,9 TS ER A ANYPROPRETONPARTNERrEXECUTIVE Y� NrA EIG138236703 09/08/2014 09/0812015 EL.EACHACCIDENT $ 1,000,00 OFFICF PeEI,0EREXCLUDED'r (Mandatory iri NH) E L.DISEASE-EA EhVtOYE $ 1,000,00 under ml- OF OPERATIONS WOW E L.DI„EA8E-POLICY 1-I91iT I S 1,000,00 B Property 21-X0158486646000 09/28/2014 09/2812015 Contents 200,000 B Crime 2LX0159496646000 09/28/2014 0912812015 Fidelity 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD iD1,AdMona3 Remarks Schedule,if more space Is required) Professional Liability #02LX0158496646000 9/28%14 to 9/28/15 Limits $1,000,000/$3,000,000 Aggregate CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. Finance&Admin.Services Allison Chambers AUr)(ORIZEDR£PR£S£NTATIVE PO Box 8181 Hillsborou h NC 27278 ° l O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and[ago are registered marks of ACORD