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HomeMy WebLinkAbout2013-352 Finance - Marian Cheek Jackson Center Outside Agency ad�3 3S1 2013-14 OUTSIDE AGENCY PERFORMANCE AGREEMENT This Agreement, made and entered into the first day of July 2013, by and between the County of Orange, a political subdivision of the State of North Carolina, 200 South Cameron Street, Hillsborough, North Carolina, 27278, ("County") and Marian Cheek Jackson Center, a not-for-profit corporation, located at 510 W. Rosemary St., NC 27516 ("Provider"). WITNESSETH: WHEREAS, it is in the interests of the County that said program be assisted by the County and thereby enhance its availability to residents of the County, and said program addresses an important community human services need,as identified by the Board of Commissioners; NOW, THEREFORE, in consideration of the above and the mutual covenants and conditions hereafter set forth, the County and Marian Cheek Jackson Center agree as follows: 1. Term of the Agreement. The term of this Agreement shall be a program year beginning July 1,2013 to June 30,2014. 2. Scope of Services. a. Provider will provide services, as outlined in the attached Outside Agency Funding Application Scope of Services and any amendments or revision thereto which is attached as Exhibit "A" and incorporated by reference, to the residents of Orange County. The Scope of Services may be different from the original application based on County appropriation; however, any revisions or amendments to this Agreement must be approved in writing by the County and attached to this Agreement. b. The Provider shall be solely responsible for the means, methods, techniques, sequence, safety program and procedures necessary to properly and fully complete the work set forth in the Scope of Services. 3. Funding. a. The County agrees to appropriate for the provision of services described in Exhibit A, Scope of Services and more particularly described in the Program Budget,the maximum sum of$4,500. b. All funds appropriated shall be used for purposes described in Exhibit A. Any funds not used for the purposes stated shall be returned to the County. Any substantive changes in the use of funds must be authorized in writing by the County prior to any expenditure of the funds by the Provider. If the funds are expended not in accordance with the Scope of Services, at the (Marian Cheek Jackson Center) Orange County Outside Agency Performance Agreement Page 1 of 8 discretion of the County the Provider may be required to repay the funds to the County. c. The County's obligation to make each payment is contingent upon receipt of Progress Reports and satisfactory progress toward completion of performance measures and accounting of expenditures as detailed in the attached Scope of Services. d. The Provider shall be paid in four equal installments in the amount of $1,125, contingent upon receipt of the request for reimbursement and related supporting documentation. The first installment shall be paid no later than August 30 of the Program year only if execution of this Outside Agency Performance Agreement by both the County and the Provider is completed by August 15 of the program year; the remaining installments shall be disbursed on January 31,April 30 and July 23 of the program year and upon satisfactory completion of(c) and the information included in this paragraph. e. Once Provider has satisfied its obligations as provided in (c) and (d) above, payment will be made 30 days after receipt of the Progress Report and Request for Reimbursement or 30 days after due date of Progress Report whichever is later. f. The County is not obligated to provide any other support to Provider in this or in succeeding fiscal years. 4. Agency Reporting. a. Provider will provide Orange County a report that includes a fiscal report, updates on 2013-14 performance measures and objectives as provided in Scope of Services. Progress Report dates are:July 1 —December 31;January 1 —March 31 and April 1 -June 30. Reports are due on January 15,April 15, and July 8 of the program year. b. Reports shall be forwarded to the Orange County Manager's Office. c. Provider agrees to allow the County to inspect its financial books and records, which document costs of those services, upon reasonable notice during normal working hours. 5. Termination. a. In the event of any of the circumstances set forth below (hereinafter referred to as "default"), the County may immediately terminate this Agreement, in whole or in part, and from time to time. Notice of termination must be in writing, state the reason or reasons for the termination, and specify the effective date of the termination: (Marian Cheek Jackson Center) Orange County Outside Agency Performance Agreement Page 2 of 8 i. In the event that Provider shall cease to exist as an organization or shall enter bankruptcy proceedings,be declared insolvent,or liquidate all or substantially all of its assets, or significantly reduce its services or accessibility to Orange County residents during the term of this Agreement; or ii. In the event that Provider shall fail to render a satisfactory accounting as provided section 4 above, the County may terminate this Agreement and Provider shall return all payments already made to it by the County for services which have not been provided or for which no satisfactory accounting has been rendered;or iii. In the event of any fraudulent representation by the Provider in an invoice or other verification required to obtain payment under this Agreement or other dishonesty on a material matter relating to the performance of services under this Agreement. iv. Nonperformance,incomplete service or performance, or failure to satisfactorily perform any part of the work identified in the Scope of Services or to comply with any provision of this Agreement,as determined by the County in its sole discretion. v. Failure to adhere to the terms of applicable county, state or federal laws,regulations, or stated public policy. b. In the event of default by the Provider, the county may elect to terminate this Agreement, in whole or in part and/or require the Provider to repay the funds within ten (10) business days from written notice of default. The County may (but shall not be required to) grant the Provider an opportunity to cure the default without termination of this Agreement. This clause shall not be interpreted to limit the County's remedies in law or in equity. c. Notwithstanding the foregoing, either party may terminate the agreement at any time without penalty; provided that written notice of such termination is furnished to the other party at least 30 days prior to termination. In the event of such termination, any payment due shall be prorated to the date of termination and any unused funds shall be returned to the County within 10 days of termination. d. Any termination of this Agreement for default under this section that is later deemed to be unjustified shall be deemed a termination for convenience. 6. Insurance. a. General Requirements. The Provider shall purchase and maintain, during the period of performance of this Agreement,insurance: (Marian Cbeek Jackson Center) Orange County Outude Agency Performance Agreement Page 3 of 8 i. Worker's Compensation. For protection from claims under workers' or workmen's compensation acts; ii. Comprehensive General Liability Insurance covering claims arising out of or relating to bodily injury,including bodily injury, sickness, disease or death of any of the Consultant's employees or any other person and to real and personal property including loss of use resulting thereof; iii. Comprehensive Automobile Liability Insurance,including hired and non-owned vehicles,if any,covering personal injury or death,and property damage;and iv. Professional Liability Insurance, covering personal injury,bodily injury and property damage and claims arising out of or related to the performance under this Agreement by the Consultant or his agents, consultants and employees. b. Limits of Coverage: Minimum limits of insurance coverage shall be as follows: INSURANCE DESCRIPTION MINIMUM REQUIRED COVERAGE • Worker's Compensation Limits for Coverage A- Statutory State NC &Coverage B -Employers Liability $500,000 each accident, disease policy limit and disease each employee • Commercial General $1,000,000 Each Occurrence Liability $2,000,000 Aggregate • Automobile Liability $500,000 Combined Single Limit • Professional Liability $1,000,000 Each Occurrence $2,000,000 Aggregate c. All insurance policies (with the exception of Worker's Compensation and Professional Liability) required under this Agreement shall name the County as an additional insured party and as a certificate holder. Evidence of such insurance and all correspondence shall be sent to: Orange County Risk Manager Post Office Box 8181 Hillsborough,NC 27278 d. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. (Marian Cheek Jackson Center) Orange County Outude Agency Performance Agreement Page 4 of 8 7. Relationship of the Parties. Provider is an independent contractor of the County. Provider represents that they has or will secure, at his own expense, all personnel required in performing the services under this Agreement. Such personnel shall not be employees or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully qualified and shall be authorized and permitted under federal, state and local law to perform such services. 8. Compliance with all Laws. The Provider, at its sole expense, shall comply with all laws, ordinances, orders and regulations of the federal, state or local governments, as well as their respective departments, commissions,boards, and officers,which are in effect at the time of execution of this Agreement or are adopted at any time following execution of this agreement. 9. Subcontract. The County and Provider deem the services provided under this Agreement to be personal in nature and Provider may not subcontract any rights or duties under this Agreement to any other party without prior written consent from the County. 10. Assignment. The Provider shall not assign this Agreement, including the rights to payment, to any other party without the prior written consent of the County. 11. Indemnification. Provider agrees to defend, indemnify, and hold harmless the County, for all loss, liability, claims or expense (including reasonable attorney's fees) arising from bodily injury, including death or property damage, to any person or persons caused in whole or in part by the negligence or willful misconduct of the Provider, except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this section to require Provider to indemnify the County to the extent permitted under North Carolina law. Nothing in this section is intended to affect or abrogate the County's sovereign immunity defenses. 12. Non-Appropriation. This Agreement is subject to the availability of funds to purchase the specified services and may be terminated at any time if such funds become unavailable. 13. Non-Discrimination. Provider agrees as part of consideration of the granting of funds by Orange County the parties hereto for themselves, their agents, officials, employees and servants agree not to discriminate in any manner of these basis of race, color,gender,national origin, age,handicap,religion, sexual orientation, familial status or veterans status with reference to any activities carried out by the grantee,no matter how remote. The parties hereto further agree in all respects to conform to the provision and intent of Orange County Civil Rights Ordinance, as amended. This provision is enforced by action for specific performance, injunctive relief, or other remedy as by law provided; this provision shall be binding on the grantees, the successors and assigns of the parties hereto with reference to the above subject manner. (Marian Cheek Jackson Center) Orange County Outside Agency Performance Agreement Page 5 of 8 14. Living Wage. Orange County is committed to providing its employees with a living wage and encourages agencies if funds to pursue the same goal. The County's living wage is $10.97 per hour. To the extent possible, Orange County recommends that Marian Cheek Jackson Center provide a living wage to its employees. 15. Notice. The Parties hereto agree and understand that written notice, mailed or delivered, to the last known address shall constitute sufficient notice to the County and the Provider. All notices required and/or made pursuant to this Agreement to be given to the County and the Provides shall be in writing and mailed to the party addressed as follows: County: County Manager's Office Provider: )d� °h 1, l- Orange County iO w Kmf±n L'J Post Office Box 8181 ape.( :► ,►Ji, Z7�I� Hillsborough,NC 27278 16. Entire Agreement. This Agreement, including any referenced attachments, constitutes the entire Agreement between the parties and shall supersede, replace or nullify any and all prior Agreements of understandings;written or oral,relating to the matters set forth herein,and any such prior Agreements or understandings shall have no force or affect whatsoever on this Agreement. The County and Provider have read this Agreement and agree to be bound by all of its terms, and further agree that this Agreement constitutes the complete and exclusive statement of the Agreement between the County and Provider. 17. Severability. All clauses found herein shall act independently of each other. If a clause is found to be illegal or unenforceable, it shall have no effect on the other provisions of this Agreement. It is understood by the parties hereto that if any part, term or provision of this Agreement is by the Courts held to be illegal or in conflict with any laws of the State of North Carolina or the United States, the validity of the remaining portions or provisions shall not be affected, and the rights and obligations of the parties shall be construed and enforced as if the Agreement did not contain the particular part, term or provision held to be invalid. 18. Governing Law. The laws of the State of North Carolina shall govern all aspects of this Agreement. In the event that it is necessary for either party to initiate legal action regarding this Agreement, venue shall lie in Orange County, North Carolina. The parties hereby waive their right to trial by jury in any action,proceeding or claim, arising out of this Agreement,which may be brought by either of the parties. [SIGNATURES ON FOLLOWING PAGE] (Marian Cheek Jackson Center) Orange County Outside Agency Per Agmement Page 6 of 8 IN WITNESS WHEREOF,the Orange County and the Provider have signed this Agreement, effective on the last date this Agreement is signed by both Parties as indicated by the dates set forth under signatures below. For and on behalfofthe Provider Lj�� Kf � / !_ In Namee rt Date For d b if ra e Co ty Government unty anager Dat App orm and legal sufficiency l � Anne e M. M re, S Attorney Date Approved as to technical content: This instrument has been pre-audited in the manner required by the Local Government Bunnd��g^^e--t and Fiscal acon of Act f Clarence Grier, Assistant County Manager/ Date Chief Financial Officer (Mahan Cheek Jackson Center) Orange County Outride Agency Performance Agreement Page7of8 ATTACHMENT "A" Orange County Certifications —FY 2013 - 14 Outside Agency Performance Agreement Chief Contact,Administrators,Chief Executive Officer and Chief Financial Officer I certify that I have provided a list of the chief contact,administrators, chief executive officer and chief financial officer for my agency with this Agreement and that I will keep it current to the County of Orange. The list should be in writing with the name,title, residential address; phone and email address and if possible, fax number. Officers and Board of Directors I certify that I have provided a current list of the Officers and Board of Directors with this Agreement and that we will continue to update the list as changes occur. The list should be in writing,with the name, physical address,mailing address and if possible,phone, fax and email address. Budget Submission I certify that I have provided a budget for the period to be covered by funding Orange County, and that any substantive changes made to this budget have been in advance authorized in writing by Orange County. Annual Financial Review I certify that I have provided a copy of the latest annual Financial Review for our agency and the budget adopted by the agency for the fiscal years encompassing this Agreement. If not,please explain on a separate sheet of paper. Alignment with Organization's Mission I certify that the programs and services for which this funding is requested align with the mission of the organization. Intended Purpose I certify that the funds provided to the agency under the terms of this Agreement will be used for a public purpose and shall only be used for the purposes intended and any money not used for those purposes will be promptly returned to Orange County. Certified by: AjAs, `.�-�Title: .Q,,� C; et C / Date: f1 '3 (Marian Cheek Jackson Center) Orange County Outside Agency Performance Agreement Page 8 of 8 Submit Form Exhibit A—Scope of Services—Fiscal Year 2013-14 Orange County Outside Agency Performance Agreement Certification Funded Amount: $ 4500 Agency: Marian Cheek Jackson Center for Saving and Making History Agency Mission: The mission of the Marian Cheek Jackson Center for Saving and Making History is to ensure the diversity, vitality, and historical integrity of neighborhoods in transition. The Center aims to preserve, to engage, and to act on rich histories of change. Program: Our Civic Media program encompasses five key projects--our nationally-recognized youth radio program(Fusion Youth Radio), our hand-delivered community newspaper(Northside News), our neighborhood audio tour(History of Homes Soundwalk), our precinct advocacy network and mappinq database, and our community forums. Purpose: The Jackson Center's Civic Media Program utilizes and connects our existing communication networks and forums to increase civic engagement and local leadership across age, race, and class. Civic Media is defined as"communication that strengthens the social bonds within a community or creates a strong sense of civic engagement among its residents." Our Civic Media Program is centered on that: intergenerational dialogue, resident engagement, connectedness, community ownership, and creative expression. Outcomes: 1) Deepen and widen our distribution and involvement networks throughout communities of change in Orange County 2) Improve the connection between media reach and participation in community action 3) Mobilize additional resources and expertise through collaboration with University,Town, and non-profit agency partners 4)Cultivate, develop, and sustain leadership from within the community 5) Educate ourselves and all civic media participants on means, visions, and challenges of social change Budget for Orange County Funding: Category Amount Expense Description Personnel $4500 Salary support for.5 FTE Civic Media Coordinator to carry out the program above ,-j I Certified by: -' Title:k -4 Date: T MARICHE OP ID:DC CERTIFICATE OF LIABILITY INSURANCE DATE/29/2 V01 08/29/23 3 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must 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). PRODUCER Phone:919-682-4814 NAME:ONTACT Debbie Callahan The Sorgi Insurance Agency Fax:919-682-4906 q"CNN Ed:919-682-4814 FAX,No):919 16 Consultant Place Suite 102 E-MAIL Durham,NC 27707 ADDREss:debbie@sorgiinsurance.com James E.Sorgi,CIC INSURER(5)AFFORDING COVERAGE NAIC# INSURER A:Erie Insurance Exchange 26271 INSURED Marian Cheek Jackson Center INSURER B: for Saving and Making History INSURER C: 512 West Rosemary St Chapel Hill, NC 27510 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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. INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MM/DDY� MMIDDIIYYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X Q970503239 08/15/2013 08/15/2014 REMIS O RENTED $ 1000,00 PREMISES Ea occurrence CLAIMS-MADE 1XI OCCUR MED EX P(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO- LOC $ AUTOMOBILE LIABILITY (Ea accdentSINGLE LIMIT $ 1,0 00'00 A ANY AUTO Q970503239 08/15/2013 08/15/2014 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X accident) $ AUTOS Per $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ D RETENTION$ $ WORKERS COMPENSATION X I WC STATU- OTH- AND EMPLOYERS'LIABILITY LIMITS I A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑N Q921501020 08/15/2013 08/15/2014 E.L.EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? NIP` (Mandato in NH) E.L.DISEASE-EA EMPLOYEE $ 100,OU ry If yes,describe under 500,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Town of Chapel Hill and Orange County are named as additional insured in regard to General Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Chapel Hill and ACCORDANCE WITH THE POLICY PROVISIONS. Orange County 405 Martin Luther King Blvd AUTHORIZED REPRESENTATIVE Chapel Hill,NC 27514 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD --� MARICHE OP ID:DC ACORN F DATE(MMIDD/YYYY) `,...� CERTIFICATE OF LIABILITY INSURANCE 08/30/2013 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must 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). PRODUCER Phone:919-682-4814 NAMEACT Debbie Callahan The Sorgi Insurance Agency Fax:919-682-4906 PHONE 919-682-4814 A,c No): 919-682-4906 16 Consultant Place Suite 102 A/C No Ext Durham,NC 27707 EMAIL James E.Sorgi,CIC AnnREss,debbie@sorgiinsurance.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Erie Insurance Exchange 26271 INSURED Marian Cheek Jackson Center INSURER B: for Saving and Making History INSURER C 512 West Rosemary St Chapel Hill, NC 27510 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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.EXP INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MM/DDY /YYYY MMIDDY LTR IYYYY I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X Q970503239 08/15/2013 08/1512014 AMAGE T RENTED 1,000,000 000 000 PREMISES Ea occurrence $ CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO LOC $JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ A ANY AUTO X 0970503239 08/15/2013 08/15/2014 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PeOra Eden DAMAGE $ AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X WC STATU RY I OR AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 0921501020 08/15/2013 08/15/2014 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? ❑ N/P' (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ SOO,UO If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500, DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Town of Chapel Hill and Orange County are named as additional insured in regard to General Liability and Auto Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Risk Manager ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD MARICHE OP ID:DC ,4�co�Ram CERTIFICATE OF LIABILITY INSURANCE UATE11/133/2013 12013 (M 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(!es) must 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). PRODUCER CONTACT The PRODUCER i Insurance Agency Phone:919-682-4814 NAME: Debbie Callahan 16 Consultant Place Suite 102 Fax:919-682-4906 (A",c No Ext:919-682-4814 aIC No):919-682-4906 Durham,NC 27707 ADDRE James E.Sorg!,CIC SS:debbie@sorgiinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Erie Insurance Exchange 26271 INSURED Marian Cheek Jackson Center INSURER B:Westchester Fire Insurance Co for Saving and Making History INSURERC: 512 West Rosemary St Chapel Hill, NC 27510 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MM/DDIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 AMAGE To A X COMMERCIAL GENERAL LIABILITY X Q970603239 08/15/2013 08/15/2014 PREMISES Ea occurrence $ 1,000,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO- LOC $ AUTOMOBILE LIABILITY EOMaBIINdEDtSINGLE LIMIT 11000,000 A ANY AUTO X Q970503239 08/15/2013 08/15/2014 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Peraccident) $ AUTOS AUTOS X HIRED AUTOS X AUTOS ED PerraccdenDAMAGE $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X I WC STATU- I OTH- AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN N Q921501020 08/15/2013 08/1512014 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,00 B Professional Liab. G27096666001 11/05/2013 11/0512014 Prof Liab 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Town of Chapel Hill and Orange County are named as additional insured in regard to General Liability and Auto Liability. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Risk Manager THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 Y 9 ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD