2020-928-E Aging - Meals on Wheels outside agency agreement

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DocuSign Envelope ID:51A7Al37-A286-4E98-B5F2-Al7F8C86549D NCCHAP7 ACORD. CERTIFICATE OF LIABILITY INSURANCE F DATE YYY) 5/2020 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 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 Nayab Alam The CIMA Companies, Inc. PHONE 703-778-7304 FAX 703-778-7354 A/C,No,Ext: (A/C,No): 2750 Killarney Dr, Suite 202 E-MAIL ss: nalam@cimaworld.com Woodbridge,VA 22192-4124 CUSTOMER ID#: 703 739-9300 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A:Alliance of Nonprofits for Ins 10023 Chapel Hill-Carrboro Meals on Wheels INSURER B:Hartford Underwriters Insurance 30104 dba Meals on Wheels Orange County, NC INSURER C: `7 Carolina Casualty Insurance Com 10510 PO Box 2102 INSURER D: Chapel Hill, NC 27515 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 NSR D POLICY NUMBER MM/DD MM/DD/YYYY LIMITS A GENERAL LIABILITY 202036882 07/01/2020 07/01/2021 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $500,000 CLAIMS-MADE F* OCCUR MED EXP(Any one person) $20,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO LOC $ A AUTOMOBILE LIABILITY 202036882 07/01/2020 07/01/2021 (E BINEDjSINGLE LIMIT $1 000000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ X HIRED AUTOS (Per accident) X NON-OWNED AUTOS $ $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION 6S60UBOG11045218 07/01/2020 07/01/2021 X WCSTATU- OTH- AND EMPLOYERS'LIABILITY T RY LIMIT ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $100,000 OFFICER/MEMBER EXCLUDED? �N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 A Liquor Liab 202036882 07/01/2020 07/01/2021 1,000,000 C D&O DCP1231894P8 07/03/2020 07/03/2021 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) The certificate holder is hereby listed as an additional insured. CERTIFICATE HOLDER CANCELLATION Orange County Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Attn: Risk Manager ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 8181, Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION.All rights reserved. ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S391951/M389620 N PA