2018-466-E Finance - Farmer Foodshare outside agency agreement

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DocuSign Envelope ID: 3F05AA6E -4F62- 4678- 8F07- 34D6E1679E9A FARME -3 OP ID: C CERTIFICATE OF LIABILITY INSURANCE FATEIMMcDDYYYYI y 0713112018 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 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 919 - 932 -9990 CONTACT Chesley Kalnen Lee -Moore Insurance Agency Inc PHON P.O. Box 667 y NC. No. 919- 932 -9$90 FAX 919- 933 -0155 West End, NC 27376 E -MAIL LAIC. No): ADDRESS'- -' r��9mail.GOin Alex Maiolo -- fNSURER(S) AFFORDING COVERAGE NAJCV INSURER A: AUTO-OWN ERS INS_. COMPANY INsuRED Farmer Foodshare INSURER 13 :AON Association Services Gini Bell - - DuN Mangum St INSURER C: Durham, NC 27701 INSURER D INSURER E: INSURER F 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. SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _LIMITS INSR TYPE OF INSURANCE AD DL SIJBR POLICY NUMBER LIR POLICY EFF POLICY EXP ? LIMITS A x COMMERCIAL GENERAL LIABILITY CLAII.IS -MADE X OCCUR Y 95269000 EACH_OCCURRENCE 06/1512018 0611512019 ( DAAMAGE 7O RENTE0 PREMISE 2,000,000 5_ S 300,000 MED EXR Any one pemoni 5 10,000 PERSONAL 6 ADV INJURY S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES P €R: POLICY E] j CT ❑ LOD f:ENERALAGGREGAT€ . PRODUCT C.RMPIOPAGG S 2,000,600 , $ 2,000,000 OTHER. _ _ S A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 S BODILY INJURY Par arson X ANY AUTO 5126900000 0611512018 06/15=191 $ O'+VNED SCHEDULED -_ AUT��Opp'S ONLY AALLITOS (BODILY INJURY IPer aairlerdi gp AUTO5ONLY qUT u�NLY ^T AMAGE S UMBRELLALIAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS -MADE AGGREGATE 5 DED RETENTION $ I A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN App NY PROPREEIETggO�R7PARTNERIEXECUTIVE [MandaloryinMNjEXCLUDED? F NIA f352786t1i PER I Eorf X 05129/2018 05129/2019 AC ER_ 1,000,000 t L EACH ACCIDENT 5 E DISEASE • EA EMPLOYEE 5 1.000,D00 If yes. ae5criba undo/ DESCRIP710N QF ERATIONS below E L DISEASE - POLICY LIMIT _ 1,000,000 ! B D$B Liability NFP0128555 -00 06115/2018 0611512019 DIDLI 1.000,000 DESCRIPTION OF OPERATIONS; LOCATIONS 1 VEHICLES (ACORO 161, Addwonal RemarMs Schedule, may be attached,} mdre space Is required) Orange County, its officers, official agents, and employees are listed as additional insured on General Liability policy, TOM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g y ACCORDANCE WITH THE POLICY PROVISIONS, Risk Management 200 S Cameron St Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE y, ACORD 25 (2016103) (71988.2015 CORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks Of ACC] D