2018-447-E Finance - OE Enterprises Inc performance agreement

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DocuSign Envelope ID: A0992361- 7662- 4FD7- 9DB3- 9D76OE06A5D2 ACCOR" CERTIFICATE OF LIABILITY INSURANCE r AaJM�a,8 YI 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 an this certificate does not confer rights to the Certificate holder in lieu of such endorsement(s), PRODUCER NAME CT Tammy Srown Jennings Bryan - Chappell Insurance Services PO Box 1118 PHONE {336) 227 -7458 (336) 343.1000 A70 No E :t : AIC. Na n aQ R €Lss. tammyb@jbcins.com INSURE R(S) AFFORDING COVERAGE NAIL # Burlington INC 27216 INSURER A: Philadelphia Indeminity Ins. Co. 18058 INSURED INSURER B: Accident Fund General Insurance Company 12304 OE Enterprises, Inc. INSURER C: $ 100.000 348 Elizabeth Brady Road INSURER a $ 5.000 INSURER E : Hillsborough INC 27278 INSURER F: COVERAGES CERTIFICATE NUMBER: CL187303754 14"ISION! NI]PARFR- THIS ISTO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTNTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 07HER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 INSR WVO POLICY NUMBER POLICY EFP POLICY EXP fMMIDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS•MADE OCCUR _fflMTD= EACH OCCURRENCE 5 11000,000 PREMISES Ea oocurrerre $ 100.000 MED EXP (Any One person) $ 5.000 PERSONAL aADV INJURY s 1,000,000 A PHPKI845734 06/3012018 06130!2019 GENT AGGREGATE LIMIT APPLIES PER: PR0j - LOC POLICY U GENERAL AGGREGATE S 2.000.000 PRODUCTS - COMPIOPAGG 5 2.000.000 Employee Benefits s 1,000.000 OTHER: AUTOMOBILE LIABILITY COMBIN €D SINGLE LIMIT Ea aocxient g 1000000 BODILY INJURY (per person) _ 3 ANYAUTO A OWNED SCHEDULED AUTOS ONLY AUTOS PHPK1845734 0613072018 06/30/2019 BODILY INJURY Peraoddam) 3 HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per acridenl S Medical payments S 5,000 x UMBRELLA LIAB I X OCCUR EACH OCCURRENCL S 4.000,000 AGGREGATE S 4,000,000 A EXCESS UAS CLAIMS -MADE PHUB637164 06/30/2018 05130/2019 DEO I ^ RETENTION S 10.000 rd B WORKERS COMPENSATION AND EMPLOYERS` LIABILITY ANY PROPRILTORIPARTNE E;XECUTiVE YIN i UFRCLR+MEMBER EXCLUOEE7� (Mandatory in NH) If describe under DESCRIPTION OF OPERATIONS be4ow NIA ,2000021234 0710112018 _ 07/01/2019 STATUTE X ERR, E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 - E.L. DISEASE - PIULICY LIMIT S SOO,p00 A Professional Liability Sexual AbuselMalestafian PHSD1361269 06730f2018 06130/2019 $1,000,000 $1,000,000 $2,000,000 $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required &Ma Z's 1111a Nf!'IIR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. P.O. BOX 5101 AUTHORIZED REPRESENTATIVE HIIlsborough. NC 27275 " -I, •I, ®1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD