2017-001-E Health - Dispute Settlement Center for anti-harrassment training

Browse Search

Docun Envelope ID: F63B22D5-E938-4B8C-949A-DCD76DAB4F01 A�iJ CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDlYYYI) 9/7/2016 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). PRODUCER CONTACT Crystal Ireland NAME: Business Insurers of Carolinas PHONE o ext1: (919)968-4611 FAX No):(919)968-8991 800 Eastowne Drive, Suite 208 ADDRE SS:oireland @business—insurers.eom PO Box 2536 INSURER(S)AFFORDING COVERAGE NAIC# Chapel Hill NC 27515-2536 - INSURER HanLilton Mutual Insurance Co 14125 INSURED INSURER B Employers Mutual Casualty 21415 DISPUTE SETTLEMENT CENTER INC INSURERC: 302 W WEAVER ST STE A INSURER D: INSURER E: CARRBORO NC 27510-6004 INSURERF: . COVERAGES CERTIFICATE NUMBER:CL166315431 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSD 4WD POLICY NUMBER (MM!DDIYYYY) (MM!DD/YYYY1 X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 —DAMAGE TO RENTED A CLAIMS-MADE X OCCUR PREMISES Ea occurrence) $ 300,000_ , 4W54487 6/17/2016 6/17/2017 MED EXP{Any one person) _ $ 5,000 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: Hired/borrowed $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS • HIRED AUTOS NON-OWNED PROPERTY t}AMAGE $ AUTOS _ $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS DAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X I PER 0TH- AND EMPLOYERS'LIABILITY f STATUTE ER Y!N ANY PROPRIETOR/PARTNER/EXECUTIVE N!A E.L.EACH ACCIDENT $ 100,040 OFFICER/MEMBER in H)EXCLUDED? 4H54467 6/17/2016 6/17/2017 E.L.DISEASE-EA EMPLOYEE $ 100,000 B (Mandatory in NH) If yes,describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION jethompson @orangecountync_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE C Ireland/IRELOI e �,/� • ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(Oman1ti .