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DocuSign Envelope ID:71441 DDA-7E15-4159-AOF1-9E6104D56C41
<br /> AC DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 9/29/2017
<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 /> 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 CONTACT Brooke Steiner
<br /> NAME:
<br /> Charlson-Wilson Insurance jvc,NN0,Ext): (785)537-1600 FAX No): (785)537-1657
<br /> 555 Poyntz Avenue, Suite 205 ADDRESS:bsteiner @charlsonwilson.com
<br /> P.O. Box 1989 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Manhattan KS 66505-1989 INSURERA:Chubb Group of Ins. Companies 6411
<br /> INSURED INSURER B:
<br /> CivicPlus, Inc. INSURER C:
<br /> 302 S. 4th Street, Suite 500 INSURERD:
<br /> INSURER E:
<br /> Manhattan KS 66502 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:2017-2018 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP W LIMITS
<br /> LTR INSD VD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY)
<br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000
<br /> DAMAGE RETED
<br /> A CLAIMS-MADE X OCCUR PREMISES O(Ea occurrence) $ 2,000,000
<br /> 3602-53-12 5/17/2017 5/17/2018 MED EXP(Any one person) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> X POLICY PRO-
<br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: 3602-53-12 5/17/2017 5/17/2018 Technology E&O $ 3,000,000
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> A ALL OWNED SCHEDULED
<br /> AUTOS AUTOS (16) 7358-87-92 5/17/2017 5/17/2018 BODILY INJURY(Per accident) $
<br /> NON-OWNED PROPERTY DAMAGE $
<br /> HIRED AUTOS AUTOS (Per accident)
<br /> Terrorism $
<br /> X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000
<br /> A EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br /> DED RETENTION$ 7989-49-14 5/17/2017 5/17/2018 $
<br /> WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> A (Mandatory in NH) (17)7174-92-49 5/17/2017 5/17/2018 E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> A Directors & Officers 8242-9361 5/17/2017 5/17/2018 Aggregate Limit $1,000,000
<br /> A Cyber Liability 3602-53-12 5/17/2017 5/17/2018 Aggregate Limit $3,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange County, North Carolina THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 200 S. Cameron Street ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Hillsborough, NC 27278
<br /> AUTHORIZED REPRESENTATIVE
<br /> Brooke Steiner/TAL ' -°" ""� ° --- ""'`
<br /> ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
<br /> INS025(201401)
<br />
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