2015-509-E Finance - El Centro Hispano, Inc. - 2015-16 Outside Agency Performance Agreement

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DocuSign Envelope ID:9B184EC2-DDAC-4169-919A-66A84379E917 ___1 ELCENTR-01 PIKSHI ACC3REY DATE IMMiDDIYYYY) lIli � CERTIFICATE OF LIABILITY INSURANCE 8/412015 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 INSUREII 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 NAME: IAS Associates,LLC PHONE l!g19 277-1330 tF'AX No; 919 287-2995 5001 Weston Parkway Suite 105 AIC No Ext:l ) Cary,NC 27513 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Philadelphia Indemnity Insurance Company INSURED INSURER B:Philadelphia Insurance Company El Centro Hispano,Inc. INSURER C: 600 East Main Street INSURER D: Durham,NC 27701 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 UER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICYNUMBER MMIDDIYYYY MMIDDlYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE IX I OCCUR PHPK1319028 0410612015 04/06/2016 PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY 7 PRO - MT EI LCC PRODUCTS-COMPIOP AGG $ 2,000,000 OTHER: $ A COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ 1 000,000 Ea accident , A ANY AUTO PHPK1152648 04/06/2014 04/06/2015 BODILY INJURY(per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accfdent) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE PHUB495856 04/06/2015 04106/2016 AGGREGATE $ DED X I RETENTION$ 10,000 [Aggregate $ 1,000,000 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN STATUTE ERH ANY PROPRIETORIPARTNER/EXECJTIVE ❑ E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Crime(Includes Burg PHPK1319028 04/0612015 04/0612016 Employee Dishonesty 120,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Risk Manager THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Or Or nge 81$1 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE Q 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD