Orange County NC Website
DocuSign Envelope ID:246A3B97-8291-4AO9-9B7C-80AF9135F8B9 <br /> REFUGEE-02 VDEC M <br /> '4CaR� CERTIFICATE OF LIABILITY INSURANCE DAT 71911oD1YYYY} <br /> `—� 71s12019 <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 poiicy(Ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not Confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER C AJACT <br /> Summers Thompson Lawry,Inc. we°,Nn EA):(919)8fi$-0412 FAX Na;(919)942,4221 <br /> 2113 Cameron Street <br /> Suite 219 ;INSURERC; <br /> A SS;Vicky@STL]nsure.com <br /> Raleigh,INC 27605-1370 <br /> INSURER(S)S AFFORDING COVERAGE _ NAM p _ <br /> RER A;Alliance for Non-Profits for Insurance Risk Retention Group 10023 <br /> INSURED RER B <br /> Refugee Community Partnership <br /> P.O.Box 461 INSURERD <br /> Carrboro,NC 27510 <br /> INSURER E r <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. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 NUMBER POLICY EFF POLICY EXP LIMITS w <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> ^ CLAIMS-MADE OCCUR x 2019-53764 21112019 2/1/2020 DAMAGE TO RENTED S 500,000 <br /> PH EM ISES(EaMED EXP Ww one arson 20,000 <br /> PERSONAL&ADV INJURY 1,000,000 <br /> GEN'LAGGREGATE U�MIT APPUES PER: GENERAL AGGREGATE S 2,000,000 <br /> POLICY❑JECT LOC PRODUCTS-COMPlOPAGG S 2,000,000 <br /> OTHER: � -- <br /> A AUTOMOWLELIABILITY COMBINED SINGLE LIMIT 1,000,OOD <br /> gang - <br /> ANY AUTO 2019-53764 2/1/2019 2/1/2020 BOOILY INJURY Per rson <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY PeraWdent S <br /> x AUTOS ONLY x Ai1TOS ONLY Per PROPER t MAGE $ <br /> $ <br /> UMBRELLA IUAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAR CLAIMS-MADE <br /> _.. — — i AGGREGATE-_ $ <br /> DED RETENTION 5 S <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN <br /> ANY CCPRpOr�PPRIIETgR <br /> OgRIPARTNERIEXECUTIVE ❑ NIA A E.L.EACH ACC DENT <br /> [MdAdatoly In NH}EXCLUDED? <br /> E.L DISEASE-EA EMPLOYE <br /> If ESC yes,RIFT ION <br /> under E.LDISEASE-POLICY LIMIT <br /> DRIPTIONN OPERATIONS below <br /> A General Liability 2019-53764 211/2019 211/2020 SAM Occ/Agg 1,000,000 <br /> A General Liability 2019.53764 2/1/2019 21112020 PE&O Occ/Agg 1,000,000 <br /> I <br /> DESCRIPTION OF OPERATIONS I LOCATION SI VEHICLES JACORD 101,AddlIonaI Remarks Schedule,may pe attached If more space is required} <br /> Certificate holder is added as Additohal Insured as repects General Liability as required by written contract <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Risk Manager THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g y 9 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough,NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />