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DocuSign Envelope ID:7F6941 1F7Fe0o3351 | <br /> ' --- DATE(M�DD/YYYY) <br /> CERTIFICATE OF LIABILITY <br /> INSURANCE I2/3I/2016 ^ <br /> THIS CERTIFICATEIS 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 CERTIFICATE HOLDER. <br /> -- - <br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this <br /> certificate does not confer n�ms��h°cerun=�e h��.rmn=uvv such enmo,sem°nqp). __ <br /> ��"C° CONTACT <br /> NAME: <br /> BB&T INSURANCE SERVICES INC/PBS PHONE m* (866) 467-8730 FAX (888) 443-6lI2 <br /> �=" __- <br /> 372545 P: (866) 467-8730 F: (888) 443-5II�2 °,""°°= <br /> PO BOX 29611 <br /> INSURER(S)AFFORDING ww� <br /> CHARLOTTE NC 28229 <br /> INSURER A: o°"��"�� z"" Co LTD <br /> INSURED INSURER B: --------- -- -- <br /> '="""«"' <br /> COMMUNITY EMPOWERMENT FUND ="""�"»' <br /> ' —"--- -- <br /> 208 N COLUMBIA ST STE 100 INSURER <br /> CHAPEL HILL NC 27514 INSURER <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS 10 CERTIFY 1IIAr TI-IE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED [0 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> /woICarEo NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH nsopsc/ ro WHICH THIS- <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br /> rsnmo.Exc/un/nwcxwocowomowsnrxoCnpouocx.umnnx*owwwxxHAveaspwnpooCeoovpmocLa/mx. <br /> ^mn ��ur�=u�^cu ^nmSmm � POLICY POLICY LIMITS <br /> - <br /> zuo urm ^�� .°°"°"'' ..i2uMIou/lzri,_ ______- <br /> rvMw�CwLGENERAL u^n/u= EA <br /> DAMAGE $2, 000, 000 <br /> »^Mmsc TO RENTED <br /> 111 vL^/wn'mne » OCCUR l OOO' O <br /> 0O pnsw/�S��cs���) , ' <br /> A x Genera l ',lab 22 uaM omyosz 01/26/2 017 01/26/2018 msoeP(Any°� =" > $10, 000 <br /> . psqaowm^mm/^u�x ,2, 00O, O0O <br /> -__ __ <br /> GENERAL $4, 000, 000 <br /> C^�'AGGREGATE uw/r^p�/sxPER: <br /> POLICY� � PRO-[^'�|mo <br /> | �e��\ � paonvmS'coMpmr^GG `4, 000, 0 00 <br /> | <br /> OTHER: $ <br /> --, ---- --- ------ --------- COMBINED — <br /> AUTOMOBILE LIABILITY S2, 000, 000 <br /> �u="�� <br /> ANY BODILY s <br /> --- — � <br /> �nwwcu m;�snv��o a 22 ��n amna�� o�/z*/znz/ o�/cs/zozo �w/������� � � <br /> AUTOS ONLY <br /> HIRED x NON-OWNED PR�rnr,DAMAGE <br /> �nwn � Own (Per ---- ---- <br /> � =**°� ° <br /> ` <br /> ��� __�� <br /> UMBRELLA OCCUR EACH OCCURRENCE , <br /> __ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE � <br /> _ __ D� R���w$ <br /> . "m"�"aOUP^musw <br /> UM- <br /> AND~=LOm=`LV°uTY ---S,~'` E ^_-"R_ , <br /> ANY rnvpmsroR/p "rwsRJEmrvnvEYw s.L.s^CnACCIDENT <br /> npnrsmwEwosRsxcLvncn, <br /> —�l -__�^ <br /> (Mandatary ������~^os E�_—^sm PL CJY <br /> -E ` <br /> __- "| If describe under E.�DISEASE'pp'/cYoM� <br /> - _I ocSC*IPnnwopopEnATION2**"° ___ <br /> DESCR1P DON OFmEF?AnONS/mCAnONS/VEHICORSORD,01.Additional Remarks Schedule,may be attached if more space is required) <br /> Those usual to the Insured's Operations. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> DELIVERED w ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Town of Chapel Hill AUTHORIZED"="ESE°'^"`= _ <br /> 405 MARTIN LUTHER KING JR BLVD '�m~r - <br /> � ' . / .—~.—' \-- <br /> . CHAPEL HILL, NC 27514 <br /> , ---©1988-2o15ACQRD Colk-15-orlIATION.All rights reserved. <br /> ACORQ25(3V1a/o3) The ACORD name and logo are registered marks of ACORD <br /> . <br />