2019-048-E Human Rights Relations - WRAL digitized outreach

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DocuSign>Envelope ID: D8F707E1-7CF1-49C1-987C-5822B8OF6851 CBCNE-1 OP ID: KIDA ACaMaR CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) 01/25/2019 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 endorsements . PRODUCER 919-878-9412 CONTACT Highsmith Insurance Highsmith Insurance PHONE 919-878-9412 FAX 919-256-1969 a Marsh&McLennan Agency LLC (A/C,No,Ext): (A/C,No): 3700 Glenwood Ave.,Suite 430 E-MAIL Raleigh,NC 27612 ADDRESS: Adrian B. Bond INSURERS AFFORDING COVERAGE NAIC# INSURER A:Vigilant Ins.Co. INSURED Capitol Holding Company Inc INSURER B:Great Northern CBC New Media Group,LLC INSURER c:Chubb Indemnity Ins Co. 11446 Post Office Bo 1800 Raleigh, NC 27605 INSURER D Federal Insurance Co INSURER E: 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRYYY MM D A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE � PRE OCCUR 37105916 01/01/2019 01/01/2020 DAM MISES AGES(Ea occu RENTED rrence 1,000,000 $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PE LOC PRODUCTS-COMP/OP AGG $ 2,000,000 17 F7 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO 74997189 01/01/2019 01/01/2020 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PerOaccidenDAMAGE $ AUTOS ONLY AUTOS ONLY L $ D X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 20,000,000 EXCESS LIAB CLAIMS-MADE 79753434 01/01/2019 01/01/2020 AGGREGATE $ 20,000,000 DIED RETENTION$ C WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY STER ER 71713481 01/01/2019 01/01/2020 500,000 ANY PROPRIETOR/P /EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDEXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT D MEDIAGUARD 81660220 01/01/2019 01/01/2020 PER OCCUR 10,000,000 AGGREGATE 10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ORANGEC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ORANGE COUNTY HEALTH AND THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. HUMAN SERVICES 200 S CAMERON ST AUTHORIZED REPRESENTATIVE HILLSBOROUGH, INC 27278 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD