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DocuSign Envelope ID:3E18098A-813F-4AA9-AFD6-8E2DC5CF7E57 <br /> (4 <br /> RISK MANAGEMENT <br /> 0 SF M Tel 919.647.0000 Fax 919.715.0067 <br /> MIKE CAUSEY,INSURANCE COMMISSIONER&STATE FIRE MARSHAL <br /> I NSURANCEE DEPARTMENT BRIAN TAYLOR,CHIEF STATE FIRE MARSHAL <br /> CERTIFICATE OF COVERAGE <br /> Certificate Holder: To Whom It May Concern <br /> Insurer: State of North Carolina <br /> Authorization: Public Officers & Employee Liability Insurance Commission of <br /> North Carolina and the General Statutes of North Carolina, Chapter <br /> 143, Articles 31 to 31 D, Sections §143-291 to §143-300. <br /> Period: October 1, 2019 until October 1, 2020 <br /> Coverage: A) Tort Claims against Departments, Agencies, and Employees <br /> B) Excess Liability for State Employees <br /> BRIT Global Specialty USA - Policy# PK1035818 „ <br /> C) Workers' Compensation <br /> Limits A) $1,000,000 for Tort claims against the State <br /> B) $2,000,000 per employee/$10,000,000 aggregate for claims <br /> against state employees <br /> C) Statutory Limits for Workers' Compensation <br /> Description: The University of North Carolina at Chapel Hill and its employees, <br /> officers, agents, as covered by the Defense of State Employees as <br /> per NCGS § 143 300.2. <br /> Administrator: Department Insurance - Risk Management Division <br /> Public Officers & Employees Liability Insurance Commission <br /> 1202 Mail Service Center, Raleigh, NC 27699-1202 <br /> Note: This Certificate is for informational purposes only and does not alter <br /> any provision of the Tort Claims or Defense of State Employees <br /> General Statutes of the State. <br /> Verified By: <br /> Margie Boyd <br /> Risk Manager <br /> UNCCH 2O19-2020 <br /> OFFICE OF STATE FIRE MARSHAL <br /> 1202 MAIL SERVICE CENTER I RALEIGH,NC 27699-1202 1 WWW.NCDOI.COM/OSFM <br />