2018-634-E Finance - Movement of Youth outside agency agreement

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DocuSign Envelope ID:7399BACD-OCBF-4EF4-9068-B429A8CA12F8 MOVEM-1 ,a►CC7R[7 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY) �— 09125/2018 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 poficy(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 919-471-2541 CONTACT Codruta E. Roberts NAME: The Insurance Center of Durham PHONE 919-471-2541 FAX 919-471-2132 1920 Front St.,Suite 710 (Arc,No,Ext): IA1C,No): P.O.Box 15369 E-MAIL codruta@insurancecenterofdurharn.com ADDRESS: Durham,NC 27704- Codruta E.Roberts INSURER{S)AFFORDING COVERAGE NAIC N INSURER A:Philadelphia Indemnity Ins Co INSURED Movement Of Youth Inc. INSURERS:L.Iberty Mutual Ins, Co. (AWC) 406 Blackwell St Ste B030 Durham,NC 27701 INSURER C INSURER 0: INSURER E: INSURER r: COVERAGES CERTIFICATE NUMBER: REVISI N 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 ADDL SUER POLICY EFF POLICY EXP TYPE OF INSURANCE INS12 WVQ POLICY NUMBER - LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR PHPK1884875 09121/2018 09121/2019 PREMISES, 100,000 PREMISES.(Eapccur[oncQ) 5 PHPK1884875 09/2112418 09121/2019.ME EXP(Any one person) 5 5,000 PERSONAL ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X JELT LOC PRODl1C7S-COMF'!OP AG .5 Included OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,0{}0. (Ea accwerll) S ANY AUTO PHPK1884875 0912112018 09121/2019 BO D ILY I NJ U RY(Per person) ;& OWNED SCHEDULED AUTOS ONLY AUTOS- BODILY INJURY(Per accident)_S �1( HIRED X NON-OWNED PROPERTY DAMAGE S Fer accident .S AUTOS ONLY AUTD ONLY € ) UMBRELLA LIAB OCCUR - I,EACH OCCURRENCE_ .__S EXCESS LIAB CLAIMS-MADE; AGGREGATE DED RETENTION S B WORKERS COMPENSATION PER _- X OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN WC539S386381018 0210512018 02/0512019 1,000,000 ANY PROPRIETORlPARTN ERIC XECUTIVE E.L.EACH ACCIDENT 5 OF ff,CRIm EMBER EkCLUDEDa N WA A . . . (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,000 If yes describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE_-POLICY LIMIT S A .Professional Liab. PHPK'I884875 0912112018 09/2112019 Occurence 1,000,000 A ,Abuse 8 Molestatio PHPKIS84875 0912112018'0912112019;Aggregate 2,000,000 i DESCRIPTION OF OPERATIONS 1 LOCATIONS F VEHICLES (ACORD 101,Additional Remarks Schedule,may be altached If more space is required) CERTIFICATE HOLDER CANCELLATION ORAN019 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. Att Risk Manager 200 S Cameron St AUTHORIZED REPRESENTATIVE Hillsborough, NC 27278 ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD