2018-512-E Coop Ext - Carrboro Coffee LocalFest vendor agreement

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DocuSign Envelope ID: 5B86FOCC- 2E2E- 4D9B- 9E8D -1 BOCB926E5D6 CARRCOF OP ID:LH A�4 ° CERTIFICATE OF LIABILITY INSURANCE 08/27/2018 0 8 /2 712 01 8 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 Phone: 919- 682 -4814 The Sorgi Insurance Agency 16 Consultant Place Suite 102 Fax: 919 - 682 -4906 CONT Lee Hammond PHONE FAX A/C No Ext :919- 682 -4814 11, No): 919 - 682 -4906 E -MAIL ADDRESS: lee @sorgiinsurance.com Durham, NC 27707 James E. Sorgi, CIC INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Erie Insurance Exchange 26271 • INSURED Carrboro Coffee Co. Inc. Open Eye Cafe LLC INSURER B: Q971520181 03/01/2018 Sparrowhawk Mgmt. Corp. INSURER C: $ 1 000 00 INSURER D: CLAIMS -MADE � OCCUR dba Caffe Driade 101 S. Greensboro St. Carrboro, NC 27510 INSURER E MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 • X COMMERCIAL GENERAL LIABILITY X Q971520181 03/01/2018 03/01/2019 DAMAGE TO RENTED PREMISES Ea occurrence $ 1 000 00 CLAIMS -MADE � OCCUR MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,00 POLICY PRO- LOC JECT $ AUTOMOBILE LIABILITY COEa M aBINED SINGLE LIMIT ccident $ 1,000,000 BODILY INJURY (Per person) $ • ANY AUTO Q030830883 03/08/2018 03/08/2019 ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X HIRED AUTOS X NON -OWNED AUTOS UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ • WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) N/A Q870103970 03/01/2018 03/01/2019 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Emplyee Dishonesty Q971520181 0310112018 03/01/2019 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Re: Orange County Local Fest, Blackwood Farm Park, Saturday, 9/29/18 Orange County Government is an additional insured as respects general liability arising from the insured's operations. CERTIFICATE HOLDER CANCELLATION Orange County Government PO Box 8181 Hillsborough, NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD