2018-414-E Finance - Hillsborough Arts Council outside agency agreement

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p DocuSign Envelope ID: 8E8982E7 -EFF8- 4214- 979D- 9D572ED22OCC DATE(MMfDDlYYYY) UtK i 11-IL;A 1 It Ur LIABILITY INSURANCE 1/22/2018 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(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of tho policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsernent(s). PRODUCER BALLARD AGENCY INC PC Box 1559 Hillsborough, NC 27278 NAME J. David Ballard _ PHONE (919)7322158 "- ' _ (919) 732 -9636 RIC No EM) A1C,NG ADDRESS Ballard @ba11ardagencyinc . com INSURERMI AFFORDING COVERAGE NAICIP INSURER A . GREAT AMERICAN INSURANCE CO . A POLICY NUMBER INSURED HILLSBOROUGH ARTS COUNCIL PO BOX 625 HILLSBOROUGH, NC 27278 INSURER B LIMITS INSURER C INSURER D: INSURER E INSURER F I 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. tNe` I TYPE OF INSURANCE INSO W C POLICY NUMBER MMIDDIYYYY MMJRRIYYYY LIMITS I - COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE -DAMAGE s CLAIMS -MADE F-1 OCCUR TO IKEN I E07— PREMISES 'Ea occurrence S MED EXP {Any one porson] s ,� - PERSONAL & ADV 114JURY I s GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S .,. POLICY Ej jI O E1 LOC PRODUCTS - COMP/OP AGG s $ OTHER. ALTOMQB;LE 1"IL1Tr COMBINED StNULL LIMIT Ea accldont s I 8001LY INJURY (Per person) l S ANYAUTO 800ILY INJURY (Per amdenl) l S I ALL OWNED SCHEDULED AUTOS AUTOS ROPE dens (Per Is NON -OWNED HIRED AUTOS AUTOS S UMBRELLA LL4B OCCUR EACH OCCURRENCE Is EXCESS LIAB CLAIMS -MADE AGGREGATE 15 I 3 OED I RETENTIONS WORKERS COMPENSATION STATUTE ER �AN❑ EMPLOYERS' LIABILITY YIN - E.1 EACH ACCIDENT 5 ANY PRGPRIEYOPfPAftTNERdEXECUTIVE aoFFICERWEMBER EXCLUf7E0A a NIA E L DISEASE - EA EMPLOYE, S (Mandatory In NMI If yes . describe under DESCRIPTION OF OPERATIONS below E L DISEASE •POLICY LIMIT S $1,000,000 OCC WRONGFULL ff AIDIRECTOR & OFFICERS EPP4917790 1/16/181/16/19 ACTS $1,000,000 OCC LIABILITY EMPLOYMENT PRACTICES DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Addlilonal Remarks Schedule. may be attached If Moro space Is required) ' E l_ $1,000,000 AGGREGATE LIMIT CFRTIFiCATE HOLDER CANCELLATION ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE j THE PO BOX 8181 ACCORDANCE WITH DATE THEREOF. NOTICE WILL BE DELIVERED IN THE POLICY PROVISIONS. HILLSBOROUGH, NC 27278 AUTH 12ED REPRESENTATIVE I 4 cC 1988-2014 ACORD CORPORATION. All rights reserved_ ACORD25(2014101) The ACORD name and loge, are registered marks of ACORD