2018-659-E Finance - Planned Parenthood outside agency agreement

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DocuSign Envelope ID: ED368FB6-6FB1-45A7-A8CA-9AB3EAEB624E CERTIFICATE OF LIABILITY INSURANCE D0A8rI0eM0MlrsDrrYYY, 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 Marsh USA,Inc, NAME: _ 1166 Avenue of the Americas a�NE Fax A!C No New York,NY 10035 MAIL ARn:healthcare.accountsess @marsh.00m Fax:212-948-1307 CDRESS: INSURER(S)AFFORDING_COVERAGE NAIL p CN101357758-NIP-CAS-18-i9 RAL,NC GLPL INSURER A:New Hampshire Insurance Com n 23841 INSURED - INSURER B:National Union Fire Ins.Co.of PlUsbu h PA 19445 PLANNED PARENTHOOD SOUTH ATLANTIC AN AFFILIATE OF PLANNED PARENTHOOD INSURER C FEDERATION OF AMERICA,INC. INSURER D 100 S.BOYLAN AVE RALEIGH,INC 27603 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: NYC-009577927-13 REVISION NUMBER: 11 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, EXCLUSION_S AN CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE Ar)nL SUER POLICY NUMBER _ MMJDD/YY F- (MNF DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 082695195 4110112018 0110112019 EACH OCCURRENCE $ UNION AMAGE TO R 500,000 CLAIMS-MADE f j+� ±OCCUF2 _PREMISES{Ea occurrence $ _ X SIR:$100,000 MED EXP=Any one person) $ Included - PERSONAL&ADV INJURY S i'0001000 GEN'L AGGREGATE LIMIT APPLIES'PER: GENERAL AGGREGATE $ 2,000,000 POLICY�JECT I_:]LOC PRODUCTS-COMPIOP AGG $. 2,iI00,000 OTHER: E $ AUTOMOBILE LIABILITY COMBIN ft I) LE LIMIT $ a accideent) ANY AUTO BODi''-Y INJURY(Per person) $ OWNED SCHEDULED BOOILY INJURY(Per ecddent) $. AUTOS ONLY AUTOS HIRED NON-CWNEO PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY _Par accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB _ CLAIMS-MADE AGGREGATE DEL) I I RETENTION$ _ $ WORKERS COMPENSATION STATUTE ER AND -- AND EMPLOYERS'LIABILITY YIN ANYPROPRIETORIPARTNER!EXECUTIVE ❑ NIA EL.EACH ACCIDENT $ _ OFFICERIMEMBER EXCLUDEI)Y {Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yyees,dcritae under DLYS6RIPesT_iON OF OPERATIONS below E.L.DISEASE.POLICY LIMIT $ B MEDICAL PROFESSIONAL 6793786 01/0112018 0IM1 019 EACH WRONGFUL ACT $1.000,000 CLAIMS-MADE COVERAGE Program Retro Date:1111176 AGGREGATE $3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached it more space Is,required) EVIDENCE OF INSURANCE FOR ALL SITES FOR PLANNED PARENTHOOD SOUTH ATLANTIC FOR 2018,THE GENERAL LIABILITY POLICY DOES NOT CONTAIN A SPECIFIC SEXUAL MOLESTATION EXCLUSION, CERTIFICATE HOLDER CANCELLATION ORANGE COUNTY GOVERNMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN:HUMAN SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 S CAMERON STREET ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 8181 HILLSBOROUGH,NC 27276 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Ricki Fitzsimmons t7 1988.2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD