2015-653-E Arts - The ArtsCenter Arts Grant

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DocuSign Envelope ID: E006B9E0-6B06-40B4-8F37-243B8FA8D07E ARTSC-1 OP ID:MR .4G°R°Y CERTIFICATE OF LIABILITY INSURANCE DATE{MNk1DBIYYYr} 12/23/7015 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 holder In lieu of such endorsement(s). PRODUCER NAMEACT Margo G.Roberts,AAI,CISR _...__ Summers Thompson Lowry,Inc. PHONE 919-959-5300 FAX 819-942-4221 100 Europa Drive,Suite 571 INC,No,FAD; (A/C,No): Chapel H111,NC 27517 EMAIL mar o stilnsure.eom C.Duke Thompson CPCU ARM ADDRESS: 9 INSURER(5)AFFORDING COVERAGE NA IC# –_ INSURER A:Great American Ins Co of NY - INSURED The Arts Center Inc. meow 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 WITI I 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. ADDL SUER POLICY EFF POLICY EXP ILTR TYPE OF INSURANCE INSR MD POLICY NUMBER (MMIDDIYYYYI IMMIODIYYWI LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL LIABILITY PAC4296967 07/01/2015 0710112016 PREMISES0(EaoecunDence) $ - _ 100,000 CLAIMS-MADE [x]OCCUR - MED EXP(Any one person) 5 5,000 PERSONALS ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PRODUCTS-COMP/OP AGG S 2,000,000 —I POLICY I . I PL LOC Emp Ben. s 1,000,000 AUTOMOBILE LIABILITY CO BINED SINGLE LIMIT S (Ea ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acclden1) $ AUTOS AUTOS f^' NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (PER ACCIDENT) S X UMBRELLA L1AO X OCCUR EACH OCCURRENCE $ _- 1,000,000 B EXCESSLJAB CLAIMS-MAaE UMB4296968 07101/2015 07/0112016 AGGREGATE S DED I X1 RETENTIONS 10000 s WORKERS COMPENSATION IT 31 LIMf ��Dp ITS I .1 T _ -.- AND EMPLOYERS'LIABILITY Y f N ANY PROPRIETOR/PARTNER/EXECUTIVE r 1 N 1 A E.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? l I (Mandatory in NH) E.L.rHSEASE-EA EMPLOYEE $ If yes,describe under EL.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS berm/ DESCRIPTION OF OPERATIONS 1 LOCATIONS!VEHICLES(Attach ACORD 101,Additional Remarks Schedule,II 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 g 91 4,-, ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD I