2017-562-E Finance - El Centro Hispano, Inc. - Outside Agency Performance Agreement

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DocuSign Envelope ID:42FC26E4-086D-47F4-A291-0A9A8706CA60 ELCENTR-04 _ SPIKE ACORar DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 4/5/2017 THIS CERTIFICATE 1S 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 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 CONTACT Hub International Southeast PHONE FAX 4000 CentreGreen Way (Arc,No,Ext): (919)337-0000 (wc,No):(865)553-5124 Suite 140 ADDRESS: Cary,NC 27513 INSURERIS)AFFORDING COVERAGE NAIC# _ INSURER A:Philadelphia Indemnity Insurance Company 18058 INSURED INSURER B: El Centro Hispano,Inc. INSURER C: 600 East Main Street INSURER D: Durham,NC 27701 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. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD 4WD POLICY NUMBER IMM/DO/YYYYI LMM/DD/YYYYS LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PHPK1612489' 04/06/2017 04106/2018 PREMISESO R NTEDnces $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GE AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY JRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: EGT $ A COMBINED SINGLE LIMIT AU LIABILITY (Ea accident) $ _ ANY AUTO BODILY INJURY(Per person) $ OWNED TOSS ONLY SCHEDULED AUTOS pBOODILY INJURY(Per accident) $ AUTOS ONLY AUTOS ONLY (Perr accident)AMAGE $ $ A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE PHUB573161 04/06/2017 04/06/2018 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y!N STATUTE ER ANY YIGEWM�MggO�R/�EXCLUDED?ECUTIVE N!A E.L.EACH ACCIDENT $ (Mandatory m NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Crime PHPK1612489' 04/06/2017 04/06/2018 Employee Dishonesty 120,000 A Professional Liabili PHPK1612489' 04/06/2017 04/06/2018 Each Incident 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached IF more space Is requIred) Professional Liab Aggregate$3,000,000 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Government ACCORDANCE WITH THE POL CY PROVISI0 SCE WILL BE DELIVERED IN 200 S Cameron St PO Box 8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD