2015-531-E Finance - Planned Parenthood South Atlantic - 2015-16 Outside Agency Performance Agreement

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DocuSign Envelope ID:935E5DF2-2E44-4828-901E-8C6C6A7DFAE8 DATE 1P.iMfDDNWY) CERTIFICATE OF LIABILITY INSURANCE 0810712015 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 ileu of such endorsement(s). PRODUCER CONTACT Marsh USA,Inc. PRONE FAX 1166 Avenue of the Americas fArC.No Exf): (A/C,No Ne'aYork,NY 10036 E-MAIL AUn:healthcare.accountscss@marsh.com Fax:212-948-1307 ADDRESS: INSURER(5)AFFORDING COVERAGE NAIC I{ 109210-NI_P-CA_S-15.16 ROA,V GAP INSURER A:Nem Hampshire Insurance Company 23841 INSURED PLANNED PARENTHOOD SOUTH ATLANTIC INSURER B..National Union Fire Ins.Co.of Pittsburgh,PA 19445 AN AFFILIATE OF PLANNED PARENTHOOD INSURER C: FEDERATION OF AMERICA,INC. INSURER D: 2207 PETERS CREEK ROAD - f ROANOKE,VA 24017 INSURER E: _ INSURER F: COVERAGES CERTIFICATE NUMBER: NYC-008171122-03 REVISION NUMBERA 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 NTH 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, EXCLUSIONSAND 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 POLICY NUMBER MP.UDD MAVDDPYY A X COMMERCIAL GENERAL LIABILITY 082695195 01/01/2015 0110112016 EACH OCCURRENCE $ 1,000,000 CLAWS-A9ADE u OCCUR P Er91SES(EaEocw ence $ 100,000 X SIR:$100,000 HIED EXP(Anyone person) $ PERSONAL&ACV INJURY $ t,000=090 G_EN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY PRO- E LOC PRODUCTS-COMPIOPAGO 5 2,�>0W JECT OTHER: 5 AUTOMOBILE LIABILITY CO},IBINED SINGLE LIPAIT Ea accide nt $ 1000000 _ A ANY AUTO 082695195 0110112015 01!9112016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Peraccid") S X AUTOS X AUTOS PROPERTY�A3,9AGE $ HIREDAUTOS AUTOS Peracciden9 )( SIR$100,900 $ UPdBRt=LLA LIAR OCCUR EACH OCCURRENCE S EXCESS LIAR CLAIMS-1AAOE AGGREGATE $ DED RETENTIONS S WORKERS COMPENSATiON PER OTH- AND EMPLOYERS'LIABILITY Yin STATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICERMEMBEREXCLUDED? NIA 1A9andatory in NH) E.L.DISEASE-EA EA9PLOYE S yes, beunder D EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS bekry B MEDICAL PROFESSIONAL 6793286 01101!2015 0110112016 PER CLAW 51,00,000 CLAIMS-MADE COVERAGE Program Retro Date: 11`1176 AGGREGATE $3,000,00 DESCRIPTION OF OPERATIONS]LOCATIONS I VEHICLES 1ACORD 501,Additional Remarks Schedule,maybe attached If more space Is required) RE:2015-16 OUTSIDE AGENGY PERFORA4ANCE AGREL?.4ENT COUNTY OF ORANGE IS INCLUDED AS ADDITIONAL INSURED(EXCEPT WORKERS'COMPENSATION)AS THEIR INTERESTS AWAY APPEAR CERTIFICATE HOLDER CANCELLATION COUNTY OF ORANGE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN:BONNIE HAMMERSLEY,COUNTY MANAGER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 SOUTH CAMERON STREET ACCORDANCE WITH THE POLICY PROVISIONS. HILLSBOROUGH,VA 27278 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Ricki Fitzsimmons ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD