2018-318-E DSS - Diaper Bank of NC

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DocuSign Envelope ID: C4A8ABA9 -961E- 4297- 82F0- 5131739260CFF DIAPERB OP ID: S8 CERTIFICATE OF LIABILITY INSURANCE DATE 0212212018Y) D2iz2r2D18 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 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 Phone: 919- 286 -7473 Dominick Huckabee Noblin Trent Insurance Agency Fax: 919 -286 -5170 PDBo% 52239 Durham, NC: 27717-2239 CONTACT NAME: {AIC No Ext , FAX No l: E -MAIL ADDRESS: _ BPS 0705663 Steve Booth INSURERS) AFFORDING COVERAGE NAIC a INSURER A: Penn National Insurance 14990 $ 50,000 INSURED Diaper Bank of NC, Inc Michelle Old, ED do 1311 E Club Blvd INSURER B :AmTrust North America PERSONAL & ADV INJURY INSURER c GENERAL AGGREGATE Durham, INC 27704 INSURER D: PRODUCTS - COMPIOPAGG INSURER F; $ INSURER F; I COVERAGFS 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 MICH 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. fR LT TYPE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P O Box 8181 POLICY NUMBER POLICY MYYYY POLICY IDDIYYYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1 •- i OCCUR X Business Owners X BPS 0705663 0210112018 0210112019 EACH OCCURRENCE $ 1,000,00 DAMAGE 10 HFN I LEY— PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ §,40 PERSONAL & ADV INJURY $ 1,006,00 GENERAL AGGREGATE $ 2,000,00 GEN'LAGGREGATE LIMIT APPLIES PER x I POLICY PRQ LOG PRODUCTS - COMPIOPAGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS NON OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accltlanl BODILY INJURY (Per person) $ BODILY INJURY (Per accidenl) $ - PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPR I ETORIPARTNEWEXECUTIVE Yn OFFICERIMEMBER EXCLUDED? F-1 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA _ C3619574 04101/2017 0410112018 v, I WC STATU- I 10TH- R LIMITS E E.L. EACH ACCIDENT $ 100,00 E,L. DISEASE - EA EMPLOYE $ 100,00 E.L DISEASE - POLICY LIMIT S 500,00 I I DESCRIPTION OF OPERATIONS I LOCATION 5I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mare space Is required) non - profit diaper provider to needy families - distribution services for Orange County are covered rFRTIFICATF HnI DER CANCELLATION Q 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Co Government g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P O Box 8181 Hillsborough, INC 27278 AUTHORIZED REPRESENTATIVE Q 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD