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DocuSign Envelope ID:9DA2D4AC-2348-434E-9B84-9BF3524778E5
<br /> �--.' ORANCOU-04 MSUMMERS
<br /> ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)8/28/2020
<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 policy(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 /> CONTACT
<br /> PRODUCER NAME:
<br /> Summers Insurance Group PHONEI/ o,Ext; 919 968-4472 FAX 919 942-4221
<br /> 2113 Cameron Street ) ) (A/c,Noi:( )
<br /> Suite 219 6DRESS:info@STLinsure.com
<br /> Raleigh,NC 27605-1370
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Alliance for Non-Profits for Insurance Risk Retention Group 10023
<br /> INSURED INSURER B:Hartford Underwriting Insurance CompanV 30104
<br /> Orange County Partnership for INSURER C:Carolina Casualty Insurance
<br /> Young Children
<br /> 120 Providence Rd Ste 101 INSURER D:
<br /> Chapel Hill,NC 27514 INSURER E
<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. NOTWITHSTANDING 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
<br /> LTR INSR WVD MM/DD MMIDD
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ - 1,000,000
<br /> CLAIMS-MADE X OCCUR 201936915 8/10/2020 8110/202, DAMAGE TO RENTED 500,000
<br /> PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ 20,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> POLICY❑PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 3,000,000
<br /> OTHER: SSP $ 2,000,000
<br /> A AUTOMOBILE LIABILITY Ea BINEDaccttSINGLE LIMIT $ 1,000,000
<br /> ANY AUTO 201936915 8/10/2020 8/10/2021 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PeOraccident DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY
<br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
<br /> EXCESS LIAB CLAIMS-MADE 202036915UMB 8110/2020 8/10/2021 AGGREGATE $
<br /> DED X RETENTION$ 10,000 Gen Aggregate $ 1,000,000
<br /> B WORKERS COMPENSATION X I PER OTH-
<br /> AND EMPLOYERS LIABILITY YIN 22WECIT8297 10/1/2020 10/1/2021 S ER
<br /> A
<br /> E.L.EACH A 500,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE CCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? N/A 500,000
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $
<br /> If yes,describe under 500,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT
<br /> C D$O/Employment Pract 1574022 8/10/2020 8/1012021 D$O/EPLI Agg 1,000,000
<br /> A General Liability 201936915 8/10/2020 8/10/2021 Sexaul Abuse Agg. 2,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Fidelity Coverage-Travelers Casualty&Surety
<br /> Policy No.0105987727LB;Policy Term: 0 8/3 012 01 9 to 2022
<br /> $100,000 Limit of Liability;$1,000 Deductible
<br /> Sexual Conduct and Physical Abuse Coverage-Alliance for Non-Profits
<br /> Policy No.EQ2019-36915;Policy Term: 08110/20 to 08110/21
<br /> $2,000,000 Aggregate/$1,000,000 Each Claim
<br /> SEE ATTACHED ACORD 101
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange County Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 9 tY ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attention:Risk Manager
<br /> 200 S.Cameron Street
<br /> P.O Box 8181 AUTHORIZED REPRESENTATIVE
<br /> Hillsborough,NC 27278 wmiw+�.5
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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