2021-096-E Social Svc - ARC of the Triangle Cardinal managed funds

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DocuSign Envelope ID:2B362E51-9A19-4059-AA75-008A33D65AFD 1 ® DATE(MM/DD/YYYY) ACORO CERTIFICATE OF LIABILITY INSURANCE 6/17/2020 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 endorsement(s). CNTAPRODUCER NAME: Christina Luckey,CLCS,CISR Marsh&McLennan Agency LLC PHONE FAx 5605 Carnegie Blvd. A/c No Ext:704-556-3329 A/C Ne:212-948-9366 Suite 300 ADDR1ESS: christina.luckey@marshmma.com Charlotte NC 28209 INSURERS AFFORDING COVERAGE NAIC# INSURERA;Selective Insurance Company of America 12572 INSURED ARCOF-4 INSURER B:Key Risk Insurance Company 10885 The Arc of the Triangle, Inc. INSURER C:United States Liability Insurance Co 25895 1709 Legion Rd,Suite 100 Chapel Hill NC 27514 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1097109420 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 EFF POLICY EXP LIMITS LTR D WVD POLICYNUMBER MM/DD MMIDD A X COMMERCIALGENERALLIABILITY S2258874 7/1/2020 7/1/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR PREMISES Ea occurrence) ccurrence $1,000,000 MED EXP Any one person) $20,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY❑PRO LOC PRODUCTS-COMP/OP AGG $3,000,000 JECT OTHER: $ A AUTOMOBILE LIABILITY S2258874 7/1/2020 7/1/2021 COMBINED SINGLE LIMIT $1,000,000 accident IANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTYDAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLALIAB X OCCUR S2258874 7/1/2020 7/1/2021 EACH OCCURRENCE $1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 DED I I RETENTION$ $ B WORKERS COMPENSATION KEY0137206 7/4/2020 7/4/2021 AND EMPLOYERS'LIABILrrY STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE —] N/A E.L.EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 C Directors&Officers Liability ND01070176D 7/1/2020 7/1/2021 Limit of Liability 1,000,000 A Professional Liability S2258874 7/1/2020 7/1/2021 Ded 1,000 Abuse/Molestation` Limit of Liability 'See Below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) *Professional Liability//Abuse/Molestation coverage: Incident Limit$1,000,000 Aggregate$3,000,000 PROOF OF INSURANCE ONLY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Human Services P O Box 8181 AUTHORIZED REPRESENTATIVE 200 S Cameron St Hillsborough NC 27278 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD