2018-471-E Coop Ext - Piedmont Wildlife LocalFest agreement

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DocuSign Envelope ID: DE978A80 -2A4E- 4731- A2EC- 27325E248667 Created on: Friday, July 27th, 2018 at 8:24AM AC[7RC]D CERTIFICATE OF LIABILITY INSURANCE F007/2712C ATE (MMIDDn YYY) 18 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 High & Rubish Insurance Agency 6015 Farrington Road, Suite 101 NAME cT High $ Rubish Insurance Aqencv PHONE x0,819 -913- 4 FAX Ne: 919 -913 -1155 E-MAIL ADDRESS, INSURER (S? AFFORDING COVERAGE NAIC X Chapel Hill, NC 27517 INSURER A: Nautilus _Insurance Campany INSURED INSURER B INSURER C : INSURER D: 5 2„000.000 Piedmont Wildlife Center, Inc. INSURER E; 364 Leigh Farm Road Durham NC 27707 PRODUCTS - COMPIOP AGG 5 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR TYPE OF INSURANCE 1DLTS -USR POIJCY EFF POLICY EXP LIMITS LTR POLICY NUMBER MMOD MM;DD A GENERAL LIABILITY x X COMMERCIAL GENERAL LIABILITY NN967$95 09101 /18 09/01/19 EACH OCCURRENCE S PREMISES Ea occurrence $ MED EXP (Any one person) $ CLAIMS -MADE ® OCCUR PERSONAL 6 ADV INJURY S GENERAL AGGREGATE 5 2„000.000 _ PRODUCTS - COMPIOP AGG 5 GEN'L AGGREGATE LIMIT APPLIES PER: S POLICY PRO• n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) 5 ANY AUTO BODILY INJURY (Per acridenli S ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS P PROPERTY DAMAGE Per accident $ I $ UMBRELLAIJAB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE DED I I RETENTION S 5 WORKERS COMPENSATION WC STATU• OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETORiPARTNERIEXECUTIVE a E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYE $ OFFtCERrMEMBER EXCLUDED? (Mandatory in NH) NIA E DISEASE- POLICY LIMIT 5 II yes, describe under DESCRIPTION OF OPERATIONS below A PROPERTY NN967895 09/01/18 09101119$51,710 TIV DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it mote space is required) LOC: 364 Leigh Farm Rd, Durham, NC 277071 DED: $1,000.001 CO -INS: 80% 1 acv BASIS. Certificate Holder is listed as Additional Insured on a Primary Noncontributory basis per form L805 (1117). CERTIFICATE HOLDER CANCELLATION Orange County Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WrrH THE POLICY PROVISIONS. Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE C 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD