2018-415-E Finance - Historic Hillsborough Commission outside agency agreement

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DocuSign Envelope ID: C5C11FD4- 56CD- 48FD- BBD1- 95F2AFF7112B DATE(MMNDDNYYY) �-v r� ULK 1 IFI[,. A I t Ur LIABILITY INSURANCE 1/23/2018 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, I IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must he endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the pollcy, 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). CONTACT PRODUCER NAME: J. DAVID BALLARD BALLARD AGENCY INC PHONE Na (919) 732 -9636 AC Na Exl ( (919) 732-2158 wc. , PO Box 1559 y ADDRESS balla_r_ d @bal lardagencyinc . cam 2 Hillsborough, NC 7278 INSURE114181 AFFORDING COVERAGE k NAICM INSURER A : GREAT AMERICAN INSURANCE CO _ _ -- INSURED HISTORIC HILLSBOROUGH COMMISSION INSURER a GREAT AMERICAN INSURANCE CO PO BOX 922 INSURER C GREAT AMERICAN INSURANCE CO HILLSBOROUGH, NC 2727E INSURER t.> E F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POLICY PERIOD 4 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. ADDL iNSR ' TYPE OF INSURANCE MMNDDIYYYI MMNDUIYYYY LTR INSO VJVD POLICY NUMBER COMMERCIAL GENERAL LIABILITY CLAIMS-MADE L —^I OCCUR X PAC4816275 GEN'L AGGREGATE LIMIT APPLIES PER X POLICY CI JECT C LOC i 1 AUTOMOBILE LIABILITY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON - OWNED HIRED AUTOS FIAUTOS X UMBRELLA LIAR OCCUR SS LIAR UMS4816276 EXCE I CLAIMS -MADE X DEO RETENTION S 10 0 0 0 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIEfORIPARTNERNHXECUTIVE NIA OFFICEPWEMBER EXCLUDED? IMandinery In NH1 11 es, describe undo r ) R1PTION OF OPERATIONS below 2/11/17112/11/18 11/17[12/11/18 1C.iDIRECTORS & -ERSJ IEPP4917808 1/21/1811/21/1 DESCRIPTION OF OPERATION'S I LOCATIONS 1 VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is (equired) DIRECTORS & OFFICERS LIABILITY LIMITS $1,000,000 OTHER THAN EMPLOYMENT PRACTICES WRONGFUL ACTS $10,000 DONOR DATA LOSS CRISIS FUND SUBLIMIT $1,000,000 EMPLOYMENT PRACTICES WRONGFUL ACTS $150,000 ELSA DEFENSE SUBLIMIT LIMITS EACH OCCURRENCE Is 1'()001000 PREMISES Ea o=urranca S 100,000 MED EXP (Any one parson) 1$ 5,000 PERSONAL& ADV INJURY S 1 , 000 , 000 GENERAL AGGREGATE 15 3 , DOd , 000 PRODUCTS - COMPIOP AGG $ 3,000,000 -COMBINED SINGLE rl 11 Ea aocidenE BODILY INJURY (Per person) $ I I BOO ILY INJURY (Per accideni) S Per n—irlptrill Is EACH OCCURRENCE 5 $ 1'000,000 AGGREGATE 5 1, 000'990 � STATUTE I ER 5 E L EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE s E.L. DISEASE - POLICY LIMIT s I CERTIFICATE HOLDER CANCELLATION ORANGE COUNTY HUMAN SEVICES I AGENCY I PO BOX 8181 HILLSBOROUGH,NC 27278 ACORD25(2014/01) The ACORD name and logo are SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE / O 1988 -2014 ACORD CORPORATION. All rights reserved. marks of ACORD