2018-103-E County Mgr - Ergonomics Center of NC program development

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DocuSign Envelope ID: 77AEB69E- 2BOD- 4BF3- AB64- 91 FD11A920E3 IF MAST002 A�OA CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD /YYYY) 06/30/2017 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(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 919- 828 -4371 NC Assoc. of Ins. Agents, Inc. P. O. Box 1165 CONTACT Barbra M. Abrahams NAMEa PHONE 919 - 828 -4371 FAx 919 - 821 -3172 A/C, No, Ext : AIC, No): E -MAIL babrahams @iianc.com ADDRESSm Cary, NC 27512 Barbra M. Abrahams INSURERS AFFORDING COVERAGE NAIC # INSURERA:Travelers Property 8r Casualty $ INSURED State of North Carolina INSURER B: INSURER C: Attn: Bryan Heckle /NC DOI 1202 Mail Service Center DAMAGE TO RENTED PREMISES Ea occurrence Raleigh, NC 27699 -1202 INSURER D: MED EXP (Any one person) $ 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS Raleigh, NC 27699 -1202 AUTHORIZED REPRESENTATIVE COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO- JECT F7 LOC PRODUCTS - COMP /OPAGG $ $ OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ X BODILY INJURY Per person) $ 1,000,000 ANY AUTO TRJCAP104T6800TIL 07/01/2017 07/01/2018 OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident INCL ABOVE $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY BI /PD PER ACC $ 10,000,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DIED I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR /PARTNER/EXECUTIVE ❑ OFFICER /MEMBER EXCLUDED? N/A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ A HIRED PHYSICAL TRJCAP449J9525TIL 07/01/2017 07/01/2018 DAMAGE IilCeglY�ySlCal Uama "geLLIrr11LSSAV6V,CCOSTO r °epalydorW IR'Gtrl2dc1tgbddbdnaybQ 7Cf hedifmorespaceisrequired) Uco�vUeUr1agbeUounUlUy exceeds 10,000 Ibs.), whichever is less. Comp /Collision apply for 30 days from the date the rental contract becomes valid. If the value of the vehicle is higher than the Hired Physical Damage Limits and /or days of rental > 30 days than the vehicle must be scheduled in the Auto Web. CERTIFICATE HOLDER CANCELLATION NCDEPTO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE NC Dept. Insurance THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN p Of ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Margie Boyd 1202 Mail Service Center Raleigh, NC 27699 -1202 AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) @ 1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD