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2017-713-E Finance - Tides outside agency agreement
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2017-713-E Finance - Tides outside agency agreement
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Last modified
7/23/2019 4:00:38 PM
Creation date
10/2/2018 4:43:17 PM
Metadata
Fields
Template:
Contract
Date
7/1/2017
Contract Starting Date
7/1/2017
Contract Ending Date
6/30/2018
Contract Document Type
Agreement - Performance
Amount
$750.00
Document Relationships
R 2017-713-E Finance - Tides outside agency agreement
(Attachment)
Path:
\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2017
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DocuSign Envelope ID:380F50AD-C98D-426B-80DC-9Al34EB8DA24 TIDES <br /> V IIGIIITr• J 1 <br /> DATE(MM/DD/YYYY) <br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE 7/24/2017 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER NAME:ACT <br /> Felicia McAroy <br /> Marsh & McLennan Agency LLC PHON FAX <br /> A/C Ext:925 482-9300 A/C,No): 925 482-9390 <br /> Marsh & McLennan Ins Agency LLC E-MAIL SS, felicia.mcaroy@barneyandbarney.com <br /> 1340 Treat Blvd#250 Lic OH18131 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Walnut Creek,CA 94597 INSURER A:Philadelphia Indemnity Ins. 18058 <br /> INSURED INSURER B:Tokio Marine Specialty Ins. 23850 <br /> Tides Center CHCYF,#1112 INSURER C:Berkshire Hathaway Homestate Co 20044 <br /> P.O. Box 29198 INSURER D: <br /> San Francisco,CA 94129 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSR WVD POLICY NUMBER (MM/DD/YYYY MM/DD/YY <br /> A X COMMERCIAL GENERAL LIABILITY PHPK1583250 12/01/2016 12/01/2017 EACHOCCURRENCE $1000000 <br /> CLAIMS-MADE �OCCUR PREMISES(Ea RENTED <br /> ) $1,000,000 <br /> MED EXP(Any one person) s20,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> X POLICY F_]ECOT LOC PRODUCTS-COMP/OPAGG $2,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY PHPK1583250 2/01/2016 12/01/201 EOa aocideD SINGLE LIMIT 1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE <br /> AUTOS Per accident $ <br /> B UMBRELLA LIAB OCCUR PUB565168 2/01/2016 12/01/2017 EACH OCCURRENCE $10 000 000 <br /> X EXCESS LIAB X CLAIMS-MADE AGGREGATE $1 O 000 000 <br /> DIED I X I RETENTION$10 000 $ <br /> C WORKERS COMPENSATION TIWC809821 1/01/2017 01/01/201 X PTAT TE OTH- <br /> AND EMPLOYERS'LIABILITYER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? ® N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> Project: Chapel Hill -Carrboro Youth Forward,#1112. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange Count Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> g y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Attn: Allen Coleman ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P.O. Box 8181 <br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S1331700/M1140872 MANN <br />
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