2018-504-E Coop Ext - Chapel Hill Creamery LocalFest vendor agreement

Browse Search

DocuSign Envelope ID: 40ADF254- F575- 4897- 99C9- 76F81779EBDE CHAPHIL -01 APOWELI CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 08/28/2018 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. 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): Griffin Insurance Agency, Inc. PO Box 1357 Mooresville, NC 28115 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # 09/30/2018 INSURER A: Nationwide Agribusiness Insurance Company 28223 INSURED INSURER B: INSURER C: $ 5,000 Chapel Hill Creamery, LLC INSURER D: PERSONAL & ADV INJURY 615 Chapel Hill Creamery Road Chapel Hill, NC 27516 INSURER E AGGREGATE LIMIT APPLIES PER: POLICY � PE� 1:1 LOC OTHER: INSURER F: $ 2,000,000 PRODUCTS - COMP /OP AGG 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM /DD /YYYY POLICY EXP MM/DD /YYYY LIMITS • X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ] OCCUR FPKNGLN03046471215 09/30/2017 09/30/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: POLICY � PE� 1:1 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ • AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY X AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY FPKNBAN3046471215 0913012017 09/30/2018 COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Per person) $ BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE FPKNFAEN3046471215 09130/2017 09/30/2018 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICER /MEM ER EXCLUDED? ECUTIVE ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A PER OTH- STATUTE ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) © 1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County LOCaIfeSt 9 y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Blackwood Farm Park 4215 NC -86 AUTHORIZED REPRESENTATIVE Chapel Hill, NC 27514 ]AAA44 04VW ACORD 25 (2016/03) © 1988 -2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD