2017-499-E Finance - Volunteers for Youth - Outside Agency Performance Agreement

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DocuSign Envelope ID:A13A145D-D67A-4FF7-ABA9-312E380D8DD9 • A o® CERTIFICATE OF LIABILITY INSURANCE DA' ( IKIDO YYY) 4...-----' 7/10/2017 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(les) must have ADDITIONAL INSURED provisions or 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 jE CT Anita M.Chick, CIC, CISR,CIIP Marsh&McLennan Agency LLC PHONE 336-.,899-2402 FAX 212-607-6550 1400 Eastchester Drive, St 200 (Arc No Fotp (A/C,No): High Point NC 27265 SS,Anita.Chick @marshmma.com INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:Alliance Member Services 10023 INSURED VOLUN-3 INSURER B:Accident Fund General Ins Co Volunteers for Youth, Inc. INSURER C Susan Worley — 205 Lloyd St.Suite 103 INSURER D: Carrbaro NC 27510 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:848171904 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 INSD WVD POLICY NUMBER IMMPOUCY,YYYY) (MMl Dnrnm LIMITS A x COMMERCIAL GENERAL LIABILITY Y 1 2016-20727 10/1/2018 10/1/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED • CLAIMS-MADE 1 X J OCCUR' PREMISES(Ea occurrence) ,$500,000 MEC EXP(Any one pen3on) $20,000 , ' PERSONAL&ADV INJURY $1,000,000 • • • GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 , POLICY PET LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 2016-20727 10/1/2016 10/1/2017 COMBIN)SINGLE LIMIT $4 000 000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X AIRED X NON S NED PROPERTY dn).DAMAGE $ AUTOS ONLY AUTOS DNLY (Per accident). I $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LWB CLAIMS-MADE AGGREGATE $ • DED I j RETENTION$ $ — B WORKERS COMPENSATION 1 WCV6116809 10/1/2016 10/1/2017 X PER I 0TH- ER AND EMPLOYERS'LIABILITY YIN STA ...... ANY PROPRIETOR/PARTNER/EXECUTIVE N!A 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 Improper Sexual Conduct 2016-20727 10/1/2016 10/1/2017 Unit 500,000 DESCRIPTION Of OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is moulted) Certificate holder is recognized as additional insured in respects to General Liability when required by written contract with the named insured. CERTIFICATE HOLDER CANCELLATION 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 POUCY PROVISIONS. Hillsborough NC 27278 - AUTHORIZED REPRESENTATIVE i,. ::,t21.4664".4.." giticisi I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD