2019-179-E AMS - CRA Link lower level contract amendment

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DocuSign Envelope ID:5046519B-8BB1-4E3B-8A31-B79D798F18B6 70E (MMIDDlYYYY) p® CERTIFICATE OF LIABILITY INSURANCE 711312018 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 1NSURER(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 Crystal Ireland NAME: Business Insurers of Carolinas PHONE {919)9fi8 4611 FAX (919)968-8991 IPA No Ext: AIC No 800 Eastowne Drive,Suite 208 vE-MAILss: cireland@business-insurers.com PO Box 2536 INSURERS)AFFORDING COVERAGE NAIL# Chapel Hill NC 27515-2536 INSURERA: Tri-State Ins Co of Minnesota 31003 INSURED INSURER B: Union Insurance Company 25844 CRA Associates,Inc INSURER C: Stonewood Ins,Co. 11 B28 222 Cloister Court INSURER D: INSURER E: Chapel Hill NC 27514 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1871322810 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 ADDLSUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD Vivo POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ 300,000 MED EXP(Any one person) $ 10,000 A Y ADV4298780-43 07/09/2018 07109/2019 PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE g 2,000,000 X PRO 2,000,000 POLICY ❑ JECT LOC PRODUCTS $ OTHER: Cyber coverage s 100.000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED CNA429886243 07/09/2018 07/09/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY H AUTOS ONLY Per.accident Hired and Non-Owned $ 1.000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 4.000,000 B EXCESS LIAB CLAIMS-MADE CNA429886243 07/09/2018 07/09/2019 AGGREGATE S 4,000,000 DEC) I X1 RETENTIONS 0 S WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE X v r N ER ANY PROPRIETORIPARTNEWEXECUTIVE E.L.EACH ACCIDENT S 500,DDD C OFFICERWEMBER EXCLUDED? NIA WC1000002205 2017A 12/31/2017 12/31/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,descnize under 500,400 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Umbrella follows form GL,Auto,&WC DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Orange County is included as additional insured in reference to the General Liability policy per written contract per attached policy forms CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough NC 27278 O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD