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DocuSign Envelope ID: B17DD799-4020-41C5-A5D6-217533E39C68 <br /> GRF-ACIIA-01 VDECAMP <br /> DATE(MMIDDfYYYY) <br /> ��- CERTIFICATE OF LIABILITY INSURANCE � 101112019 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS <br /> CERTIFICATE ODES 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($),AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder In lieu of such endorsements). <br /> G��p��yy77ppGT <br /> PRODUCER I <br /> Summers Thompson Lowry,Inc. ;PHONP --- FAX--•_........_._....-- _ --__-- <br /> 2113 Cameron Street (AIC,No,Ex§:(919)968-4472 <br /> [E-M IL .._.. .. <br /> Suite 219 I, ©°��S§_Vicky.§TLinsure.corn <br /> Ralelgh,NC 27605-1370 I --- — --.._—.... ------ <br /> _•__—„• NSURER�S]AFFORDING,COVERAGE NAICN . <br /> -. --.--..- .. .- ----••iNsuRERA;First Nonpmfit InBurAncs,Co• <br /> INSURED INSURER B:Utica National•Ins:Group_—___ <br /> Greater Cha pel Hili•Carrboro INSURERC: <br /> Chamber Of Commerce _.�_.__._.. _-•-•- <br /> 104 S.Estes Drive#101 FIN SURER U i-.----•--... ...-•--------- ----- —.... -- <br /> Chapel Hill,AIC 27514 INSURERS: <br /> INSURERF: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTTY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDIT)ON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS I <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 1 <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ILT R TYPE OF INSURANCE ADOL$U6R POLICY NUMBER M;DDCY YEFF POLICY EXP LIMITS <br /> A I X COM ME RCIA L GENERAL LIABILITY 1 000,000 <br /> 1 <br /> EACH O[;CURRENCE-_ _-- � 'CLAIMS-MADE ! ](�OCCUR 1 NPP100270204 1/5/2019 115/2020 DAMAGETORENTED 10080 <br /> ,.PR-EMI$E$.[Eaayqurleg•i�g]—a-g•_,_ - ------- _ <br /> i_.._...._._...-•----. I MED EXP <br /> 5000 <br /> �4 ' <br /> knRSONAL&_AAV INJURY__-__-_ <br /> 1,000,000 <br /> GEN'L AGGREGATE LIMITAPP_LIESPER: j f i GSNERAL-AGGREGATE —'$_-_•. •_ 3,000,000 <br /> - POLICY�— 'j j j LOC I PRODUCTS__OOkP10PAGG B4OOO,Ot}0 <br /> 1 OTHER: S <br /> A AUTOMOBILE LIABILITY iCMBIREEDDSINGLE LIMIT = 1,000,000 <br /> X I ANY AUTO NCA1008029 02 115/2019 1 1IW2020 I pgplLYINJURYLperpel'eanL_;__-•W -_----____-__-_ <br /> OWNED — SCHEDULED <br /> AU�T�O�S ONLY IA�UpTNCpS} �p -BODILY IIrNJURY{Per exldamy..; <br /> {_--_I AUTOS ONLY E-- AU705 ONLY �Pe�aoEdderIEMAGE _ -—--- _ <br /> A !.X 'UMBRELLA LIAR' I X OCCUR EACH OCCLJRRENCt _..__ 2,000,000 ) <br /> EXCESS LIAD •.CLAIMS-MADE; 1NMB100270303 116/2019 1/5/2020 AGGREGATE____......— _•5 �------------ <br /> DE❑ I X s 10,000� j Aggregate - 2,01)Q,OI]l3 { <br /> B •WORKERS COMPENSATION I PER <br /> AND EMPLOYERS'LIABIIJTY Y f N _ a9T.ATUTE. ]R-- <br /> a606W 12/31/2018 12I3112019 500,0tia <br /> ANY PROPRIEPO)EXCLUDED?ECUTIVE E.L.EACH ACCIDENT _.-$-••_-_ -_ <br /> AFICER�InM,�EM EXCLUDED? N 1 A <br /> ancdetary in" F.L.DISEASE-EA EMPI_OY_- •�.----......__600,000 <br /> Ir yes deecNbe older 54q�� <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> I <br /> I <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be allac had If more space Is required) <br /> Informational Purposes Only <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATIO DATE THEREOF, <br /> Greater Chapel Hill-Carrboro Chamber of Commerce ACCORDANCE WITH THE POLICYPROVISIONSCE WILL BE DELIVERED IN <br /> 104 S. Estes Drive#101 <br /> Chapel Hill,NC 27518 -- <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016103) 9)1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />