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Client#: 73888 NCHILL2
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<br /> DocuSign Envelope ID:9B26E979-2C09-4BE7-801C-3DDB484D92EE DATE(MM/DDIYYYY)
<br /> ti IL,kor IN Ul, tocrs. lir I t•/A I C. kJ r L'ABILITY II SLJRANCE 1131/2017
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<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> 1 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT' If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to
<br /> the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER
<br /> NAME:
<br /> The CIMA Companies, Inc, PHONE 703 739-9300
<br /> (A/C,Nu,Ext); 0761 703739
<br /> rAx
<br /> -
<br /> ? 2750 Killarney Or Suite 202 EMAIl
<br /> ADDRESS:
<br /> ' Woodbridge, VA 22192-4124 ''PP ODUC FR
<br /> CUSTOMER ID 0
<br /> 703 739-9300
<br /> INSURER(S)AFFORDING COVERAGE ,NAIC P
<br /> INS UR ED INSURER A,Alliance of Nonprofits for Ins 10023
<br /> Orange County Rural Alliance (OCRA)
<br /> INSURER 13
<br /> 4901 Schley Road
<br /> INSURER C:
<br /> , Hillsborough, NC 27278 '
<br /> ,
<br /> INSURER D
<br /> INSURER E
<br /> _ INSURER F:
<br /> ,............................_____________
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> -------
<br /> I HIS 6 10 DER I IF Y THAI [I-1E POLICIES OF INSURANCE L ISTED BELOW I IAVE BEEN ISSUED TO THE INSURED NAMED ABOVE EOR TI IE POLICY PERIOD
<br /> IN DrAT ED.NOT WITI ISTANDING ANY REQUIREMEN1,TERM OR CONDITION OF ANY CONTRACT OR OT I-IER DOCUMENT win I RESPECT TO WHICH TI IIS ,
<br /> CEH f WICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT'TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SI IOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,
<br /> I nin"--"—"------ ADDL UN,, ' POLICY EFF POLICY EXP ' ---
<br /> TYPE Or INSURANCE N,FR vo ; POLICY NUMBER 'MM/00/YYYY MM/DD1YYYY LIMITS
<br /> , A GENERAI LIABII ITY 201750439 01/31/2017 01/31/20181 EACH OCCURRENCF E11,000,000
<br /> _
<br /> 1 PAMAG[T,10 RENTED rinn Ann ,
<br /> X commr$kcli ( F1JERAi I,IABIE 11Y I [ PREMISES(T',1ti 0,,C1.111Ufil,t,f s,,,,,,,...w ,
<br /> CLAIM MADE E X OCCUR
<br /> WO EXP(Any one purs[en) I$20,000
<br /> 1 1 PERSONAE &ACE)/INJURY 1 S1,000,000
<br /> 1 , i
<br /> ('I NE NAL ACCIRFOA YE E$2,000,000
<br /> '.1 non nnn
<br /> EN'1 AGGREtY0 1 IS LIMIT APPLIES PF.N' PROW/YTS-COMP/OP AO) $..,,vvv,v.,'
<br /> 1
<br /> 1$
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<br /> A AUTOMOBILE LIABILITY 201750439 01/31/2017 01/31./2018 comBINFD SINGE E TIMIT1 I$
<br /> 1 1 1(En accident) 1 1 000 000
<br /> ANY AUTO , 1
<br /> [ [
<br /> 1 E 11 1301)E1 Y INJURY(Per porboro $ 1
<br /> Al 1 OWNEU All(OS E I
<br /> Es'
<br /> BODILY INJTIRY(Per
<br /> ;[;1 IEDIJI,rip AU 1[08
<br /> E 1
<br /> PROPERTY DPEMACEls 1
<br /> X rIlki-D Al.„ii os
<br /> E E I(Per ortutInnt) E
<br /> ,
<br /> E r
<br /> 1E
<br /> 1 $
<br /> X NON CWNE (Al TOG E 1
<br /> ,
<br /> , 1 '
<br /> E 1 1 E $
<br /> , E —
<br /> UMBRELI.A LIAB occuB ' EACH OCCt ftRi'/NC,/,E l$
<br /> I
<br /> 1 1
<br /> EXCESS LIAO STLAIMS MADE AGGREGATE
<br /> ,
<br /> 1 E $
<br /> I)[[)1.1(StIPTI,E
<br /> 1[
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<br /> WORKERS COMPENSATION 'WC)SIAM- 01H E
<br /> ,
<br /> , AND EMPLOYERS"LIABILITY , ,TO,RYILMI-N.,... ,ER i
<br /> YIN
<br /> ANY CRC-Mills TOREPAR l'NERTEXECUrIVE— — 1 F I EACH ACCE DEN j t TE
<br /> E
<br /> (--,IF-K,E,k,Ml-MBI-1-t I.X('', LIDEDY N/A ,
<br /> (Mandatory in NH) Ett ly MI-ASE[EA IMP)OYEEE$
<br /> tl yes ricyra,r;Undel
<br /> ) /'IF or o(ERATIoNs F.,:;fr,,,, , 1 E L. DISEASE; POI W/1'I IMO. 1$
<br /> ......,—..........------____ ...___,
<br /> 1 1
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<br /> , —______,----,-------- ---1-----,--
<br /> _ .,—...i., —....L__
<br /> DI,SCRIPT ION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space e,required)
<br /> Orange County, NC is listed as additional insured under the general liability policy with respects to
<br /> operations performed by the name insured,
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> _ _....... ........_____
<br /> i Orange County, NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH'THE POLICY PROVISIONS,
<br /> AUTHORIZED REPRESENTATIVE
<br /> 01988-2009 ACORD CORPORATION,All rights reserved,
<br /> ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br /> #S345374/N1345373 JX..1
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