2017-246-E Co. Mgr. - Michigan Coalition Against Homelessness - MOU for HMIS Lead

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I, DocuSign Envelope ID:C8A96163-9727-4D52-BE22-A8D964F05312 / DATE(MM/DD/YYYY) A�o® CERTIFICATE OF LIABILITY INSURANCE 5/11/2017 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 Julie Jurkiewicz NAME: VTC Insurance Group DBA Brownrigg Companies LTD HONNE,Exq: (248)373-5580 FAX No): 1175 W. Long Lake Ste. 200 ADDRESS:77urkiewicz @vtcins.com INSURER(S)AFFORDING COVERAGE NAIL# Troy MI 48098 INSURERA:Michigan Millers Mutual Ins Co 14508 INSURED INSURER B:Special Markets Insurance " Michigan Coalition Against Homelessness INSURER C:Capital Insurance 15851 S. Old Us 27 INSURER D: INSURER E: Lansing MI 48906 INSURER F: COVERAGES CERTIFICATE NUMBER:1 6-17GL, 17-18ACC Cyber 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 ADDL S POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER LIMITS (MM/DD/YYYY) (MMIDD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED i' A CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ 100,000 X C0512123 7/27/2016 7/27/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ INCLUDED OTHER: Hired/borrowed $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A ■ ANY AUTO BODILY INJURY(Per person) $ ,ALL OWNED SCHEDULED C0512123 7/27/2016 7/27/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS © HIRED AUTOS x NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE I AGGREGATE $ I DED RETENTION$ I $ WORKERS COMPENSATION ' PER OTH- 'AND EMPLOYERS'LIABILITY STATUTE ER Y/N ,ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT - $ OFFICER/MEMBER EXCLUDED? , /A (Mandatory in NH) I I E.L.DISEASE-EA EMPLOYEE, $ If yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT I$ B jAccident-Medical 219900895 2/26/2017 2/28/2018 jLimit $500,000 C Cyber Liability 1 I CY20161063 5/04/2017 5/04/2018 Limit $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Partnership to THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN End Homelessness ACCORDANCE WITH THE POLICY PROVISIONS. 200 S Cameron AUTHORIZED REPRESENTATIVE P.O. Box 8181 Hillsborough, NC 27278 Alan Chandler/JJ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)