2015-655-E Arts - The ArtsCenter Arts Grant

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DocuSign Envelope ID:3A2943C2-EE76-446E-9116-3566395E1533 ARTSC-1 OP 1D:MR A Rt CERTIFICATE OF LIABILITY INSURANCE DATE IM�DD Y1 1 2/23/2015 i 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,tho 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). CONTACT Mar fl o G. AI,CISR PRODUCER NAME; Roberts,� ...-_ ._. Summers Thompson Lowry,Inc. PHONE 919-969-5300 I ac,He),919-942-4221 100 Europa Drive,Suite 571 AA CANo,Ext1: { Chapel Hill,NC 27517 ADDRESS:margo@stilnsure.com C.Duke Thompson GPM ARM INSURER(S)AFFORDING COVERAGE NAIL II INSURER ;Great American Ins Co of NY INSURED The Arts Center Inc. INSURER B;Great American Alliance Ins Co 300 G East Main Street Carrboro,NC 27510 INSURER c 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 RE 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. WDDL'SUPR POLICY EFF POLICY EXP ' ILLTR •TYPEOFINSURANCE IHSR WVO POLICY NUMBER _(MMIDDfYYYY) (MMIDIHYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 PREMISES i(RENTED A X COMMERCIAL GENERAL LIABILITY PAC4296967 07101/2015 07101/2016 PREMISES(Ea occurrence) S 100,000 —I CLAIMS•MADE X OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE 5 2,000,000 GE 'L AGGREGATE LIMIT APPLIES PER _PRODUCTS-COMP/OP AGG s 2,000,000 POLICY m PRO- POLICY I LOG Emp Ben. 5 1,000,000 COMBINED AUTOMOBILE LIABILITY (Ea acciden MOLE LIMIT S ANY AUTO 8OOILY INJURY(Per person) 5 ALL OWiED SCHEDULED BODILY INJURY(Pm-accident) $ _,_ AUTOS AUTOS PROPERTY DAMAGE HIRED AUTOS AUNOOWNEO (PER ACCIDENT) `-- $ - $ X UMBRELLA LIAR X^OCCUR ..EACH OCCURRENCE $... 1,000,000 B EXCESS L1AB CLA1MS•MADE UMB4296968 0710112015 07/01/2016 AGGREGATE $ DED X RETENTIONS 10000 $ WORKERS COMPENSATION TORYLIT- 0TH. . AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVF.I N f A E.L._ EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.E. DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS be E.L.DISEASE-POLICY LIMbelow . I DESCRIPTION OF OPERATIONS I LOCATIONS(VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) For Information Purposes CERTIFICATE HOLDER CANCELLATION ORANGE2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Orange County Human Services Dept. PO Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough,NC 27278 c LL 711,”44,0", ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD