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Personal Care & Assisted Living Insurance Center
<br />P.O. Box 933
<br />Hanover, PA 17331
<br />RENEWAL OF NUMBER: 2019-35634
<br />POLICY NUMBER:2020-35634PRODUCER:
<br /> COMMERCIAL LINES COMMON POLICY DECLARATIONS
<br />Voices Together
<br />NAME OF INSURED AND MAILING ADDRESS:
<br />88 Vilcom Center Dr. Suite 100
<br />Chapel Hill, NC 27514
<br />POLICY PERIOD:FROM 10/10/2020 TO 10/10/2021
<br />AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE
<br />BUSINESS DESCRIPTION: Therapeutic music program for people with developmental disabilities
<br />IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS
<br />POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY.
<br />THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THESE PREMIUMS MAY BE SUBJECT TO ADJUSTMENT.
<br />PREMIUM
<br />$664COMMERCIAL GENERAL LIABILITY COVERAGE PART - OCCURRENCE
<br />..............................................................$250COMMERCIAL AUTO LIABILITY COVERAGE PART
<br />............................
<br />.........................$1,148IMPROPER SEXUAL CONDUCT AND PHYSICAL ABUSE COVERAGE PART
<br />$840SOCIAL SERVICE PROFESSIONAL COVERAGE PART ..........................................................
<br />Not Covered................................................................................TERRORISM COVERAGE (Certified Acts)
<br />INCLUDED............................................................COMMERCIAL LIQUOR LIABILITY COVERAGE PART
<br />$2,902TOTAL:
<br />FORM(S) AND ENDORSEMENT(S) MADE A PART OF THIS POLICY AT TIME OF ISSUE:*
<br />ANI-E003 GL 08 20, ANI-E069 GL 02 19, ANI-E078 12 18, ANI-E120 09 19, ANI-E123 09 19, ANI-RRG-AL 04 01, ANI-RRG-E11 GL 09 19,
<br />ANI-RRG-E15 01 17, ANI-RRG-E22 09 19, ANI-RRG-E25 12 15, ANI-RRG-E26 11 17, ANI-RRG-E28 01 99, ANI-RRG-E29 12 09, ANI-RRG-E33 GL 09 19,
<br />ANI-RRG-E34 09 18, ANI-RRG-E42 GL 09 19, ANI-RRG-E5 07 15, ANI-RRG-E56 01 17, ANI-RRG-E59 02 12, ANI-RRG-E60 07 12, ANI-RRG-E61 02 19,
<br />ANI-RRG-E67 08 17, ANI-RRG-E70 03 19, ANI-RRG-E72 01 17, ANI-RRG-E74 03 14, ANI-RRG-GL 04 01, ANI-RRG-LL 04 01, ANI-RRG-NPO-001 05 20,
<br />ANI-RRG-SC 04 01, ANI-RRG-X1 06 18, CG 00 01 04 13, CG 00 33 04 13, CG 20 10 04 13, CG 20 12 04 13, CG 20 18 04 13,
<br />CG 20 20 11 85, CG 20 21 07 98, CG 20 26 04 13, CG 20 34 04 13, CG 20 37 04 13, CG 21 09 06 15, CG 21 47 12 07,
<br />CG 21 73 01 15, CG 21 96 03 05, CG 24 07 01 96, IL 00 17 11 98, IL 00 21 09 08, IL 02 69 09 08, SCHEDULE BA 01 80,
<br />SCHEDULE G 01 80, SCHEDULE L 01 80
<br />BY
<br />*Omits applicable forms and endorsement if shown in specific coverage part / coverage form declarations.
<br />These declarations and the common policy declarations, if applicable, together with the common policy conditions, coverage form(s) and forms
<br />and endorsements, if any, issued to form a part thereof, complete the above numbered policy.
<br />"NOTICE
<br />This policy is issued by your risk retention group. Your risk
<br />retention group may not be subject to all of the insurance laws
<br />and regulations of your State. State insurance insolvency
<br />guaranty funds are not available for your risk retention group."
<br />ANI-RRG-CO
<br />(AUTHORIZED REPRESENTATIVE)
<br />09/10/2020
<br />DocuSign Envelope ID: 81A61471-345A-47F9-8A2D-36F7929A6637
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