2015-450-E Finance - The Exchange Club's Family Center of Alamance - 2015-16 Outside Agency Performance Agreement $2,000

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DocuSign Envelope ID: DB61356E-7ACB-4248-A6B4-08C4BC04350D ACOR" DATE(MM/DD/YYYY) Ill CERTIFICATE OF LIABILITY INSURANCE 8/1,/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 Tracie Hawkins NAME: FAX The Phoenix Company, LLC PHONE No . (336)765-9332 A/C No: (336)765-7141 P.O. Box 26396 E-MAIL an tracieh @the hoenixco ADDRESS: p � y com INSURER(S)AFFORDING COVERAGE NAIC# Winston-Salem NC 27114-6396 INSURERA:Contlnental Western Ins. Co. 10804 INSURED INSURER B: Exchange Club Center for the Prevention of INSURER C: Child Abuse of North Carolina INSURER D: 500 West Northwest Boulevard INSURER E: Winston-Salem NC 27105 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1572338810 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 INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ A CLAIMS-MADE FxI OCCUR X CPA423252144 4/12/2015 4/12/2016 MED EXP(Any one person) $ 20,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 3,000,000 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWN ED SCHEDULED PA423252144 4/12/2015 4/12/2016 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ A Professional Liability CPA423252144 4/12/2015 4/12/2016 $1,000,000 Each Incident $3,000,000 Ag A Sex.Abuse/Molestation Liab CPA423252144 4/12/2015 4/12/2016 $100,000 Each Incident $300,000 Aggr DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Orange County, NC is an additional insured as respects to general liability when required by written contract. CERTIFICATE HOLDER CANCELLATION achambers @orangecountync.g SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County, NC ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Allison Chambers 200 South Cameron Street AUTHORIZED REPRESENTATIVE P.O. BOX 8181 Hillsborough, NC 27278 T Hawkins, CISR/HAWKI <74 ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. IN S02519n1nn51 n1 The arnRn name and Innn arc rcnie4crcfl marine of arnpin