OTHER-2021-049-Lease-The Preservation fund of Hillsborough-lease of property

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i C DocuSign Envelope ID : DC812C3D- BEF34DF1 -9A31 -4F7B8A72DCFD ACORU� DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE `--� 11 / 16/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S ) , AUTHORIZED ; REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. I IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy ( ies ) must have ADDITIONAL, INSURED provisions or be endorsed . If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on { this certificate does not confer rights to the certificate holder In lieu of such endorsement(s ) . i PRODUCER CONTACT NAME: Blake f SfafeFarm Ashby Insurance Agency PHONE 1919-732-1052 Fn1a No)` f 1000 Corporate Dr Suite 101 oA� biake@dckyourworld . com Hillsborough , NC 27278 INSURER( S) AFFORDING COVERAGE _ NAIC # INSURERA ; State Farm Fire and Casualty Company 26143 l INSURED INSURER B The Preservation Fund of Hillsborough INSURER C INSURER D INSURER E INSURER F ; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER ; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 1% CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . iL R TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP POLICY NUMBER MM/bDhffM- (MMIDDIYYYYILIMITS COMMERCIAL GENERAL LIABILITY 11000 , 000 EACH OCCURRENCE CLAIMS-MADE OCCUR DA U - O RENTED $ f PR EMISES IEa occurrence) $ MED EXP (Any one arson) $ 51000 A 93E7L5497 11 /01 /2021 11 /01 /2022 PERSONAL & ADVINJURY $ j MOTHER: L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000 , 000 POLICY C JECT LOC PRODUCTS - COMP/OP AGG $ $ AUTOMOBILE LIABILITY COMBINED SINGff LIMIT $ f Ea accident ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE -' AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ r' EXCESS LIAB HCLAIMS-MADE AGGREGATE $ _ j DED RETENTION $ $ WORKERS COMPENSATION _ I AND f: MPL0YER5' LIABILITY YIN STATUTE ETH { (, ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ (Mandatory In NH ) E.L. DISEASE - EA EMPLOYE $ If4as, describe under D SCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101 , Additional Remarks Schedule, maybe attached If more apace Is required) 135 Court St Hillsborough , NC 27278 l I 1 I i I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS , Orange County, NC Government PO BOX 8181 AUTHORIZE7 REPRESENTATIVE i ; Hillsborough , NC 27278 1% I � I © 1988-2015 ACORD CORPORATION , All rights reserved , j ACORD 25 (2016103 ) The ACORD name and logo are registered marks of ACORD I! 1001486 132848. 13 04-22-2020 L