2017-014-E DSS - Durham Technical Community College for employment services

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DocuSign Envelope ID:00FEOB2E-F9BE-4D36-97AE-1776640D2D7C ................N DURH-14 OP ID:KO A`©R©` CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDmYY) 12/13/2016 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(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 'warCONTACT: Barry C.Curtis ". First Insurance Services,Inc. 'PHONE 919-941-0549 FAX 918-941-0135 P.O.Box 13687 tail,EA); wc.Noy , RTP,NC 27709 1huL Barry C.Curtis INSURER(SI AFFORDING COVERAGE MAX r INSURER A:Gra phic Arts Mutual Ins,Co. 25984 INSURED Durham Technical Community INSURER e:Bridgefield Casualty Ins.Co. 10335 College, Inc. 1637 Lawson Street INSURER C: " Durham,NC 27703 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 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 yNSR ODL "'I POLICY EFF POLICY SNIP UNITS LTR TYPE Of INSURANCE NSO WW1 POLICY NUMBER )MMIOOIYYYYI IMMrOD/YYYY1 A X COMMERCIAL GENERAL LIASIUTY EACH OCCURRENCE S 1,000,001 CLAIMS-MADE X OCCUR CPP1396174 'DAMAGE EN Rs{3 occurrence} $ 50,001 MED EXP/Any one peraolli $ 5,001 P£RSONAI.I:ADV INJURY S 1,000,00 GEN'L AGGREGATE LIMIT APPLIESPER. GENERAL AGGREGATE S 3,000,001 POLICY J El ECT LOC PR • E(�� PRODUCTS.COMP/OP AGO, S 3,000,00 J OTHER: S AUTOMOBILE UABILm COMBINED SINGLE LIMIT S 1,000,001 (Es=Ace) A X my AUTO CPP1395174 07/01/2016 07101/2017 BODILY INJURY(Pot person) 3 AUTOS D AUTOSULED 'BODILY INJURY(Per scadenty S X HIRED AUTOS X AUTOS IPPROPE (DAMAGE S 5 )4 UMBRELLA UAB 1 X OCCUR EACH OCCURRENCE S 3,000,001. A exCISS LIAO CLAIMS-MADE CULP1784352 07/01/2016 07/01/2017 AGGREGATE S 3,000,001' DED I X I RETENTIONS 10,000 LL S MWORKERS COMPENSATION X I1ER 0TH. AND EMPLOYERS'LIABILITY I STATUTE ER Y B ANY PROPRIETORRARTNERIExECUTIVE ri Ni A 19632006 07101/2016 07/01/2017 E L EACH ACCIDENT S 500,001 OFFICER/MEMBER EXCLUDED? (Mandatory M NMI E L DISEASE-EA EMPLOYEE 3 500,00 I M dealzdie under 300,00 DESCRIPTION OF QPERATIQNS WOW E L DISEASE o POLICY LIMIT A School Dist Educ CP1395174$10y+/ RETAINED 07/01/2016 07/01/2017 Occurr 1,000,0 1. Liability LIMIT CLAIMS MADE Aggret 3,000,01+' DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,any be attached K more space Is requlnd) CERTIFICATE HOLDER CANCELLATION. ORANGE2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County De Ent of T'H'E EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 ty P ACCORDANCE WITH THE POLICY PROVISIONS. Social Services 113 Mayo Street PO Box 8181 AUTHCMIIiEDRSPIe88ENTaTNE Hillsborough, NC 27278 4411 J,kj r a"0I le it43/( 1906-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD