2021-601-E-Aging-Meals on Wheels of Orange Count

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DocuSign Envelope ID:4F676C90-21 E4-4097-A8AC-0087D34EB01 3 h) Solid Waste Program Fee (SWPF)Verification This fee finances Orange County's recycling and waste reduction program. Submit either a.) proof of payment of the agency's FY 2019-20 Solid Waste Program Fee, OR b.) a statement on agency letter head indicating exemption and specify the person(s), business, etc. that is responsible for paying this fee. i) Certificate of Liability Insurance A copy of the agency's current certificate,from the agency's insurance carrier. Table 1 below outlines insurance types and minimums required, for each jurisdiction. If exempt from Worker's Compensation compliance, include a statement explaining why,with the agency's application materials. NOTE: Proof of insurance is not required at the time of application submission. If your agency is approved for funding, documentation of insurance must be provided to the jurisdiction awarding the funding when the contract is awarded. The insurance certificate should reflect the funding jurisdiction as an additional insured party and certificate holder and provide coverage for the duration of the funding period (July 1 —June 30). Renewal certificates must be sent to the jurisdiction 30 days prior to any expiration date, cancellation or modification of any stipulated insurance coverage. NOTE: Upon request, insurance requirements may be reviewed on a case by case basis by the Town or County. Please contact the staff identified on the Submission Requirements on Page 2 if you have questions or would like to request a review of your insurance requirements. Table 1. Forms of Liability Insurance and Minimum Policy Amounts Required INSURANCE TOWN OF CARRBORO TOWN OF CHAPEL HILL ORANGE COUNTY3 Worker's Limits for Coverage A- Compensation' Limits for Coverage A-Statutory State NC,for Limits for Coverage A-Statutory Statutory State NC,for each each employee State NC,for each employee employee Limits for Coverage B- Limits for Coverage B-Employers Limits for Coverage B- Employers Liability of: Liability of:$100,000 Each Employers Liability of: $1 million Each Occurrence$100,000 BID for each $500,000 each accident,Occurrence employee $500,000 BID for each $1,000,000 BID limit $500,000 BID limit employee $500,000 for BID limit Commercial General $100,000 Property Liability Damage Liability $1 Million Bodily Injury $1 million Each Occurrence $1 million Each Occurrence $2 million Aggregate $2 million Aggregate and Property Damage Limit Automobile Liability $1 million Each Occurrence Not Applicable *Only required for agencies doing $1 million Each Occurrence travel as part of the agreement with the Town. Professional Liability Not Applicable $1 million Each Occurrence $1 million Each Occurrence $2 million Aggregate $2 million Aggregate Sexual Abuse& Not Applicable $1 million Each Occurrence $1 million Each Occurrence Molestation $2 million Aggregate $2 million Aggregate