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M ALLIANCE OF
<br /> ❑ NONPROFITS FOR ALLIANCE OF NONPROFITS FOR INSURANCE
<br /> INSURANCE RISK RETENTION GROUP (ANI )
<br /> www. insurancefornonprofits . org
<br /> A Head for Insurance. A Heart for Nonprofits.
<br /> COMMERCIAL LINES COMMON POLICY DECLARATIONS
<br /> PRODUCER : POLICY NUMBER : 2019 - 52335
<br /> Cima Companies , Inc . RENEWAL OF NUMBER : 2018 - 52335
<br /> 2750 Killarney Drive
<br /> Woodbridge , VA 221924124
<br /> NAME OF INSURED AND MAILING ADDRESS :
<br /> United Voices of Efland - Cheeks
<br /> P . O . Box 478
<br /> Efland , NC 27243
<br /> POLICY PERIOD : FROM 08/ 01 /2019 TO 08/ 01 /2020
<br /> AT 12 : 01 A . M . STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE
<br /> BUSINESS DESCRIPTION : Community Center
<br /> IN RETURN FOR THE PAYMENT OF THE PREMIUM , AND SUBJECT TO ALL THE TERMS OF THIS
<br /> POLICY , WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY .
<br /> THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED . THESE PREMIUMS MAY BE SUBJECT TO ADJUSTMENT .
<br /> PREMIUM
<br /> COMMERCIAL GENERAL LIABILITY COVERAGE PART - OCCURRENCE $ 760
<br /> COMMERCIAL AUTO LIABILITY COVERAGE PART . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $ 250
<br /> IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE COVERAGE PART $ 700
<br /> SOCIAL SERVICE PROFESSIONAL COVERAGE PART Not Covered
<br /> COMMERCIAL LIQUOR LIABILITY COVERAGE PART INCLUDED
<br /> TERRORISM COVERAGE ( Certified Acts ) $ 13
<br /> TOTAL . $ 13723
<br /> FORM (S ) AND ENDORSEMENT( S ) MADE A PART OF THIS POLICY AT TIME OF ISSUE : *
<br /> ANI -EO69 GL 02 19 , ANI -E078 12 18 , ANI-RRG-AL 04 01 , ANI-RRG- E03 01 131 ANI-RRG-El1 07 923 ANI- RRG- E12 05 921 AN ]-RRG-E15 01 17 ,
<br /> ANI - RRG-E22 08 95 , ANI-RRG-E25 12 151 ANI -RRG-E26 11 179 ANI -RRG -E28 01 99 , ANI -RRG -E29 12 09 , ANI -RRG-E33 01 17 , ANI-RRG -E34 09 18 ,
<br /> ANI-RRG -E42 01 17 , ANI-RRG-E5 07 15 , ANI -RRG-E56 01 17 , ANI -RRG-E59 02 12 , ANI -RRG-E60 07 121 ANI -RRG-E61 02 191 ANI-RRG-E67 08 17 ,
<br /> ANI-RRG-E70 03 19 , ANI-RRG-E72 01 17 , ANI -RRG-E74 03 14 , ANI -RRG-GL 04 01 , ANI -RRG-LL 04 01 , ANI -RRG-NPO-001 09 17 , ANI- RRG-SC 04 01 ,
<br /> ANI -RRG-X1 06 18 , CG 00 01 04 13 , CG 00 33 04 13 , CG 20 02 11 851 CG 20 10 04 13 , CG 20 12 04 13 , CG 20 18 04 13 ,
<br /> CG 20 20 11 853 CG 20 21 07 98 , CG 20 26 04 13 , CG 20 34 04 13 , CG 20 37 04 13 , CG 21 09 06 159 CG 21 47 12 07 ,
<br /> CG 21 70 01 15 , CG 22 44 04 13 , CG 24 07 01 96 , CG 77 94 04 93 , IL 00 17 11 98 , IL 02 69 09 08 , IL 09 99 01 15 ,
<br /> SCHEDULE BA 01 80 , SCHEDULE G 01 80 , SCHEDULE L 01 80
<br /> *Omits applicable forms and endorsement if shown in specific coverage part / coverage form declarations .
<br /> These declarations and the common policy declarations , if applicable , together with the common policy conditions , coverage form (s ) and forms
<br /> and endorsements , if any, issued to form a part thereof, complete the above numbered policy.
<br /> " NOTICE
<br /> This policy is issued by your risk retention group . Your risk
<br /> retention group may not be subject to all of the insurance laws BY
<br /> and regulations of your State . State insurance insolvency (AUTHORIZED REPRESENTATIVE )
<br /> guaranty funds are not available for your risk retention group . " 07/03/2019
<br /> ANI - RRG - CO (02356 - DB )
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