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DocuSign Envelope ID: 2000DA7F- 9978 -48A1- 8458- 8C7628BD4EA2 <br />Certificate of Insurance <br />Issue Date(MMlDD1YYYY) <br />4710312018 <br />Named Participant <br />This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. <br />Triangle J COG <br />This Certificate does not amend, extend or alter the coverage afforded by the Policies below. <br />Companies affording Coverage <br />4307 Emperor Blvd, Suite 110 <br />Durham„ NC 27703 <br />A = Interlocal Risk Financing Fund of North Carolina <br />B = North Carolina Interlocal Risk Management Agency <br />COVERAGES <br />THIS IS TO CERTIFY THATTHE COVERAGE LISTED BELOW IS AFFORDED TO THE PARTICIPANT NAMED ABOVE FOR THE PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY <br />CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE COVERAGE DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS., EXCLUSIONS AND CONDITIONS <br />OF SUCH PROGRAK <br />Co <br />Type of Coverage <br />Policy Number <br />Effective <br />Expiration <br />Limits of Liability <br />Ltr <br />date <br />Date <br />A <br />GENERAL LIABILITY <br />PL- 94006-2018 -00 <br />07/0112018 <br />07/0112019 <br />Products - Comp /Operations <br />$5,000,000 <br />N Commercial General Liability <br />Personal & Adv. Injury <br />$5,000.000 <br />® Claims Made 0 Occurrence <br />Each Occurrence <br />$5,000,000 <br />Fire Damage (Any one fire) <br />$1,0007000 <br />Med_ Expense (Any one person) <br />NIA <br />Deductible <br />$500 <br />A <br />AUTOMOBILE LIABILITY <br />PL- 94006 - 2018,00 <br />07/01/2018 <br />07101120019 <br />Limit <br />Deductible <br />p Any Auto (Symbol 1) <br />Combined Singh Limil$5 000.000 <br />$500 <br />A <br />® Hired Autos (Symbol 8) <br />PL- 94006- 2018-00 <br />07/01/2018 <br />07171/2019 <br />$5,000,000 <br />$500 <br />A <br />❑ Non -Owned Autos (Symbol 9) <br />PL- 94006 - 2018,00 <br />07/0112018 <br />07/0112019 <br />$5,000,000 <br />$500 <br />❑ UninsuredlUnderinsureid Motorists <br />PROPERTY <br />Limit <br />Deductible <br />❑ Real & Personal Property <br />❑ Builder's Risk <br />❑ Auto Physical Damage (Symbol 7 & 8) <br />® Municipal Equipment <br />® Computer Equipment & Media <br />❑ Portable Equipment <br />❑ Fine Arts <br />Police Professional Liability <br />Limit (per occurrencelaggregate) <br />Deductible <br />❑ Claims Made ❑ Occurrence <br />Public Officials Liability <br />Limit (per occu rfencelagg regate) <br />Deductible <br />❑ Claims Made ❑ Occurrence <br />Employment Practices Liability <br />Limit (per vccurrencelaggregate) <br />Deductible <br />❑ Claims Made [] Occurrence <br />Workers' Compensation <br />Limit <br />❑ Workers° Compensation and Employees Liability <br />Each Accident <br />❑ WC statutory Limit <br />Disease - Each Employee <br />Disease - Policy Limit <br />OTHER COVERAGE <br />Limit <br />Deductible <br />❑ <br />Description <br />Evidence of Coverage <br />Certificate holder <br />Cancellation <br />Grange County <br />Should any of the above described coverages be cancelled before <br />200 S. Cameron St. <br />the expiration date thereof the issuing company will endeavor to <br />Hillsborough, NC 27278 <br />mail 34 days written notice to the certificate holder named to the left, <br />but Failure to mail such notice shall impose no obligation or liability <br />of any kind upon the company, its agents or representatives. <br />Authorized Re' <br />ta at' <br />U � <br />