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DocuSign Envelope ID:OEB5F5E6-5CCO-4398-9C1A-EB43F7042DAC
<br /> EXCHCLU-02 ELEON
<br /> ,4coR0 CERTIFICATE OF LIABILITY INSURANCE DATE
<br /> 6/9/2 D/YYYY)
<br /> i9/2o20
<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 /> PRODUCER CONTACT Ellie Leon
<br /> NAME:
<br /> Hub International Carolinas PHONE FAX
<br /> 751 Corporate Center Drive (A/C,No,Ext): (A/C,No):
<br /> Suite 120 ADDRESS:ellie.leon@hubinternational.com
<br /> Raleigh,INC 27607
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Selective Casualty Insurance Company 14376
<br /> INSURED INSURER B:
<br /> Exchange Clubs Child Abuse Prevention Center in Durham, INSURER C:
<br /> Inc.
<br /> 3400 Croasdaile Drive Suite 206 INSURER D:
<br /> Durham,INC 27705 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 INSD WVD MM DD YYY MM DD YYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE � OCCUR S 2259412 6/28/2020 6/28/2021 DAMAGE TO RENTED 1,000,000
<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 /> X POLICYEl PECOT- LOC PRODUCTS-COMP/OP AGG $ 3,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> ANY AUTO S 2259412 6/28/2020 6/28/2021 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PROPERTY DAMAGE
<br /> AUTOS ONLY AUTOS ONLY Per accident $
<br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000
<br /> EXCESS LIAB CLAIMS-MADE S 2259412 6/28/2020 6/28/2021 AGGREGATE $ 1,000,000
<br /> DED X RETENTION$ 0 $
<br /> A WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> Y/N WC9041095 6/28/2020 6/28/2021 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> A Crime S 2259412 6/28/2020 6/28/2021 Limit 100,000
<br /> A Professional Liab. S 2259412 6/28/2020 6/28/2021 Aggregate 3,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Sample Certificate THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> p ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Exchange Clubs Child Abuse Prevention Center in Durham,In
<br /> 3400 Croasaile Dr Ste 206
<br /> Durham,NC 27705 AUTHORIZED REPRESENTATIVE
<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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