2016-617-E Finance - United Way of the Greater Triangle - Outside Agency Performance Agreement

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DocuSign Envelope ID:9859FC6D-3EEB-4C7D-9891-BE11A53D9413 l ® DATE(MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE L....../. 4/14/2016 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). CO PRODUCER NAMEACT Debbie Callahan Moore and Johnson Agency PHONE 919-582-1977 FAX 919-719-8806 P.O. Box 17867 (A/C,No,Fxt)' A/C,Not: Raleigh NC 27619 A DARESS:dcallahan @mooreandjohnson.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Selective Insurance Company 12572 INSURED UNITE-5 INSURER B:AmTrust North America United Way of the Greater INSURER C: Triangle,Inc. 2400 Perimeter Park Dr.#150 INSURER D: Morrisville NC 27560 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:456670720 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 713DL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A x COMMERCIAL GENERAL LIABILITY Y S 2070767 4/1/2016 4/1/2017 EACH OCCURRENCE $1,000,000 CLAIMS-MADE X OCCUR DAMAGE TO RENTED 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 POLICY PRO- JECT PRODUCTS AGG $2,000,000 JECT OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 2070767 4/1/2016 4/1/2017 (Ea accident) $1,000,000 ANY AUTO BODILY INJURY(Per person) $ AUTOS AUTOS SCHEDULED BODILY INJURY(Per accident) $ X HIRED AUTOS X N -OWNED PROPERTY DAMAGE $ AUTOS (Per accident) _ $ A X UMBRELLA LIAB X OCCUR S 207076701 4/1/2016 4/1/2017 EACH OCCURRENCE $2,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $2,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION SWC1103319 4/1/2016 4/1/2017 PER OTH- AND EMPLOYERS'LIABILITY YIN X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Property Section S 2070767 4/1/2016 4/1/2017 BPP 815,801 A Crime S 207076701 4/1/2016 4/1/2017 Employee Dishonesty 250,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) SVT 2400 Perimeter Park, L.P. and TP Triangle LLC their successors and assigns are additional insured with regards to General Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SVT 2400 Perimeter Park, L.P.c/o TP Triangle LLC ACCORDANCE WITH THE POLICY PROVISIONS. 3020 Carrington Mill Blvd.,Suite 425 Morrisville NC 27560 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD