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Home My WebLink About2021-051-E AMS-Compass Group USA Meadowlands vending machine DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 os Q� [Departmental Use Only] TITLE Vending Machine FY 2020/2021 ORANGE COUNTY CONTRACT UNDER $5,000.00 NORTH CAROLINA THIS AGREEMENT, is between Orange County,North Carolina,a body politic organized under the laws of the State of North Carolina, (the "County"), and Compass Group USA, Inc.by and through its Canteen Division(the "Provider"). WITNESSETH: For the purpose and subject to the terms and conditions hereinafter set forth, the County hereby contracts for the services of the Provider, and the Provider agrees to provide the services set out below to the County in accordance with the terms of this Agreement,time being of the essence. The services or materials or construction (hereinafter referred to collectively as "Services") to be furnished under this Agreement are as follows: Vending Services as set forth in Exhibit A attached hereto. The term of this agreement rendered shall be from December 1, 2020 to November 30, 2023 ("Initial Term"). Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent,professional and timely manner to the satisfaction of the County. Provider shall be responsible for all errors or omissions, in the performance of the Agreement.Provider shall correct any and all errors,omissions,discrepancies,ambiguities, mistakes or conflicts at no additional cost to the County. Provider agrees that Provider shall not sub-contract any of the services to be provided in this Agreement, nor shall Provider assign any right or responsibility granted or required by this Agreement,without the prior written approval of the County. SPECIFIC TERMS 1. Pam: If applicable,payment shall be made within thirty (30) days of an invoice properly submitted to County. Should Provider fail to perform its duties under the terms of this Agreement, County may,without fault or penalty,withhold any payment associated with the work to be performed until such time as said work is completed. 2. Non—waiver: Failure by County at any time to require the performance by Provider of any of the provisions hereof shall in no way waive or affect the County's right hereunder to enforce the same, nor shall any waiver by the County of any breach be held to be a waiver of any succeeding breach or a waiver of this Non-Waiver Clause. 3. Independent Contractor: The Provider shall operate as an independent contractor, and the County shall not be responsible for any of the Provider's acts or omissions. The Provider shall not be treated as an employee with respect to the Services performed hereunder for federal or state tax, unemployment or workers' compensation purposes. The Provider understands that neither federal, nor state, nor payroll tax of any kind shall be withheld or paid by the County on behalf of the Provider or the employees of the Provider. 4. Insurance:Provider shall obtain,at its sole expense,Commercial General Liability Insurance, Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may be required by County's Risk Manager as such insurance requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is Revised 07/20 1 DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing division/contracts.php). If County's Risk Manager determines additional insurance coverage is required such additional insurance shall be designated here (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 5. Indemni : To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend,indemnify, and hold harmless Orange County from all losses,liabilities,claims,demands, suits,costs, damages or expenses(including reasonable attorney's fees) arising from bodily injury,including death,to any person or persons or damage to or destruction of any property caused in whole or in part by any negligent or intentional act or omission on the part of the Provider in carrying out Provider's duties and obligations related to the Services to be provided in this Agreement. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 6. Termination: This Agreement may be terminated at any time after the Initial Term by mutual written agreement of the parties or by the County upon written 30 days written notice to the Provider. County may suspend this Agreement upon reasonable notice to Provider._If either party breaches this Agreement,the party claiming such breach will give written notice citing specifics. If, within 60 days from such notice,the breach is not corrected,the non-breaching parry may terminate this Agreement on 30 days written notice. 7. Entire Agreement and Sign: The parties have read this Agreement and agree to be bound by all of its terms, and further agree that it constitutes the complete and exclusive statement of the Agreement between the parties unless and until modified in writing and signed by the parties. Modifications may be evidenced by telefacsimile signature. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the parties to comply with Article 11A and Article 40 of North Carolina General Statute Chapter 66. 8. Governing Law and Priority: Both parties agree this Agreement is governed by the laws of the State of North Carolina and Orange County. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti- discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.oran eg counlync. og v/departments/purchasing division/contracts.php.). Any violation of this requirement is a breach of this Agreement and County may immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. By executing this Agreement Provider affirms Provider is and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. In determining the basic services to be provided, should any documents be referenced in or attached to this Agreement,the terms herein shall have priority in any conflict between the terms of referenced documents and the terms of this Agreement. 9. Dispute Resolution: Neither party may initiate binding arbitration. Any disputes shall be resolved by nonbinding mediation. If such mediation fails either party may initiate litigation to resolve the dispute. Should either party initiate litigation to settle any dispute involving the terms of this Agreement such litigation shall be initiated in the General Court of Justice of North Carolina seated in Orange County,North Revised 07/20 2 DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 Carolina. Regardless of the outcome of said litigation each party is responsible for its own costs and fees, including attorneys'fees. 10. Non Appropriation: Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable and not appropriated for the performance of County's obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability and non-appropriation of public funds. IN WITNESS WHEREOF,this Agreement is effective upon its execution by Orange County and the Provider. ORANGE COUNTY COMPASS GROUP USA,INC.BY AND THROUGH IT "f N DIVISION DocuSigned by: By s a .fit 9. fi� bA epff081iflYfrector Name�i�`1°i`t eF2 °Tim Bailey,Division President 200 S. Cameron St. 4808 Chesapeake Drive, Charlotte NC 28216 P.O. Box 8181 Hillsborough,NC 27278 Copy of Provider notice to: 2400 Yorkmont Road, Charlotte NC 28217 Revised 07/20 3 DocuSign Envelope ID:5EDEB981-591E-41340-919A-DCDA565AD550 Exhibit A: Vending Services DEFINITIONS Equipment:vending and other related equipment provided by Provider. Premises:405 Meadowlands Dr. Hillsborough, NC 27278 and as set for the in Exhibit B (collectively,the "Premises") Products:food, beverage and sundry products supplied by Provider. Services:Vending Services. Vending Services:the provision of Products via vending machines. TERMS AND CONDITIONS 1. RESPONSIBILITIES OF THE PARTIES. • Provider shall install, maintain and service the Equipment in accordance with industry standards. • County grants to Provider the exclusive right to provide the Services and install Equipment at the Premises. • County shall provide to Provider the necessary space (secure for the Equipment), trash removal, extermination services, internet and utilities to permit the sanitary operation of the Services. In the event that there is a disruption in utilities, County will notify Provider when County becomes aware of the disruption. • County shall maintain its Premises and service the areas around the Equipment in a sanitary manner in accordance with industry standards and laws. County will provide Provider employees access to the Equipment. County will clean the Coffee Services Equipment in accordance with manufacturer's standards. 2. EQUIPMENT. • County has no title to or interest in Equipment or Products. • County will not operate, remove or tamper with the Equipment, unless necessary in connection with the Services. County is responsible for any damage to the Equipment or Products (including theft) caused by the willful misconduct or negligent acts or omissions of County, its agents or employees. • In the event that a piece of Equipment is not generating an appropriate sales volume or revenues Provider may,in its sole discretion: (i)remove such Equipment;or(ii) implement a subsidy arrangement upon mutual agreement. 3. COUNTY INSURANCE. The County shall maintain commercial general liability insurance with policy limits of not less than $1,000,000 per occurrence,with excess coverage in an amount not less than $5,000,000 to cover claims in the aggregate, as well as property insurance against risks covered by standard forms of fire,theft and extended coverage in such amounts as appropriate. 4. EQUAL EMPLOYMENT OPPORTUNITY CERTIFICATION.The parties shall abide by the requirements of 41 CFR§§ 60-1.4(a),60-300.5(a)and 60-741.5(a).These regulations prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities,and prohibit discrimination against all individuals based on their race, color, religion, sex, sexual orientation, gender identity or national origin. Moreover, these regulations require that the parties take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disability. S. PRICE ADJUSTMENTS • If there are changes in assumptions of population, hours, other conditions, labor costs (including benefits and insurance), product costs, fuel costs, Federal, state and local taxes or laws (including regulatory or legislative mandates)or other levy or tax that impacts Provider's Services, Provider may modify the prices accordingly. • Notwithstanding the foregoing, Product prices may be adjusted by Provider annually at a rate equal to the greater of the then-current, relevant rate published for the Employment Cost Index or the national or regional Consumer Price Index. Revised 07/20 4 DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 Exhibit B—Premises Machine Totals&Locations Machine ' Location Count Machine Type 001 COURT HOUSE Court House 7 1 Snack,6 Pepsi 002 Courthouse Annex Courthouse Annex 2 1 Snack, 1 Pepsi 003 Government Annex Government Annex 1 1 Snack 004 Plannine Env Planning Env 3 1 Snack,2 Pepsi 005 Purchasing Purchasing 1 1 Pepsi 006 Recreation Dept Recreation Dept. 1 1 Pepsi 007 Southern Human Services Southern Human Services 1 1 Snack 008 Social Services Downstair Social Services Downstairs 1 1 Pepsi 009 Social Services Upstairs Social Service Upstairs 1 1 Pepsi 010 JOB LINK Job Link 1 1 Snack 011 MEADOW LANDS Meadow Lands N/A N/A 012 SEYMOUR CENTER MAIN Seymour Center Main 1 1 Coke 013 School Admin Office School Admin Office 1 1 Pepsi 014 ORANGE CO]AIL Orange Co Jail 2 1 Snack, 1 Pepsi Orange County Emergency 510 Meadowlands Dr.Hillsborough,NC 27278 23 Revised 07/20 5 DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 ORANGE COUNTY—DEPARTMENT USE ONLY Party/VencJQj Name: C ass USA Ply/Vendor Contact Person: Amy MckeP Co9ct on�919-225-9338 Party/Ven Address:l Camden Ave City Durham State: NC Zip: 27704 Departm A Amount Purpose:Vending Machine Setup at 405 Meadowlands Dr Budget Code(s): Vendor# 54356 (N/A if new vendor) Vendor is a BOCC consultant? Yes No X Contract Type:(Check one)New X Renewal Amendment Effective Date Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated p ' Dt&, "on of the agreement: Department Director's Signatur SIB QVIn, Date: 12/20/2020 Agreements for emergency services or' WI apse not'subject to the above affirmation.If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficient Di astlga :standards,specifications,and requirements: C,bvv�,e.11b 12/29/2020 Office of the Risk Management Office ±Uso-rser-s1,�aoex5 Date: DS Financial Services This instrument has been pre-audited' g,�% required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Offic 4"� 0"�� Date: 12/30/2020 7D4E5181ACC1409... Legal Services This agreement is approved as ogoDsfpmpnd sufficiency: Office of the County Attorne ,6St fL Date:1/5/2021 4C5FKDDFOB94% Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 07/20 6 DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 ATE A�" CERTIFICATE OF LIABILITY INSURANCE o12/15/2020D/YYYv) 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 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). PRODUCER CONTACT Randi K.Nowell,CPCU,ARM MARSH USA,INC. NAME: TWO ALLIANCE CENTER A/C NNo Ext: 404-995-3102 FAX No), 3560 LENOX ROAD,SUITE 2400 E-MAIL Marsh.comasscerts ATLANTA,GA 30326 ADDRESS: Com p @ INSURER(S)AFFORDING COVERAGE NAIC# CN1 02832071-Compa-UMB1 0-20- CANTE CANTV INSURER A:National Union Fire Ins Co.of Pittsburgh PA 19445 INSURED INSURER B:AIU Insurance Co 19399 Canteen Vending Services 1716 Camden Ave. INSURER C:ACE Property And Casualty Ins Co 20699 Durham,NC 27704 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-005185847-01 REVISION NUMBER: 1 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY GL1728994 09/30/2020 09/30/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO TED CLAIMS-MADE � OCCUR PREMISES ('a a occurrence) ctcur ence) $ 1,000,000 X SIR:$1,000,000 MED EXP(Any one person) $ X Contractual Liability PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X POLICY❑ PRO- POLICY ❑ LOC PRODUCTS-COMP/OP AGG $ 5,000,000 OTHER: I $ A AUTOMOBILE LIABILITY CA 4594426(AOS) 09/30/2020 09/30/2021 COEaMBINED accident SINGLE LIMIT $ 2,000,000 A X ANY AUTO CA 4594429(VA) 09/30/2020 09/30/2021 BODILY INJURY(Per person) $ A OWNED SCHEDULED CA 4594427(MA) 09/30/2020 09/30/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS A X HIRED X NON-OWNED CA4594431(Garage Liability) 09/30/2020 09/30/2021 PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Self Insured for Physical Damage $ X UMBRELLA LIAB X OCCUR X00 G27738631 09/30/2020 09/30/2021 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION WC 045886802(AOS) 09/30/2020 09/30/2021 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B Y/N WC 045886807(CA) 09/3012020 09/30/2021 2,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? N/'4 WC 045886803 FL 09/3012020 09/30/2021 (Mandatory in NH) ( ) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 B If yes,describe under WC 045886808(NY) 09/30/2020 09/30/2021 E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS below A Liquor Liability GL1728990 09/30/2020 09/30/2021 Each Common Cause 1,000,000 SIR:$1,000,000 Aggregate 10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hillsborough,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _lVi av�ao .h1J�K L ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 AGENCY CUSTOMER ID: CN102832071 LOC#: Atlanta AC"J?o ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA,INC. Canteen Vending Services 1716 Camden Ave. POLICY NUMBER Durham,NC 27704 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance Workers Compensation Continued: Carrier:New Hampshire Insurance Company Policy Number:WC 045886804 Effective Date:09/30/2020 Expiration Date:09/30/2021 Policy Covers States of:MA,WI, Stop Gap Coverage:ND,OH,WA,WY. Limit: E.L.Each Accident:$2,000,000 E.L.Disease-Policy:$2,000,000 E.L.Disease Each Employee:$2,000,000 Workers Compensation Continued: Carrier:National Union Fire Ins.Co.of PA Policy Number:XW C6559404 Effective Date:09/30/2020 Expiration Date:09/30/2021 Policy Covers States of:OH(Excess WC) Limit: E.L.Each Accident:$2,000,000 E.L.Disease-Policy:$2,000,000 E.L.Disease Each Employee:$2,000,000 -------------------------------------------------------------------------------------------------------------------------------------------------------------- ADDITIONAL INFORMATION Umbrella Liability policy provides additional limits and follows the Additional Insured and Waiver of Subrogation provision of the above captioned underlying policies as shown,if required by written contract and permitted by law. Workers Compensation Policy#WC045886802(AOS POLICY) Covers the States of: AK,AL,AR,AZ,CO,CT,DC,DE,GA,HI,IA,ID,IL,IN,KS,KY,LA,MD,ME,MI,MN,MO,MS,MT,NC,NE,NH,NJ,NM,NV,OK,OR,PA,RI,SC,SD,TN,TX,UT,VA,VT,WV ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 ATE A�" CERTIFICATE OF LIABILITY INSURANCE o12/15/2020D/YYYv) 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 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). PRODUCER CONTACT Randi K.Nowell,CPCU,ARM MARSH USA,INC. NAME: TWO ALLIANCE CENTER A/C NNo Ext: 404-995-3102 FAX No), 3560 LENOX ROAD,SUITE 2400 E-MAIL Marsh.comasscerts ATLANTA,GA 30326 ADDRESS: Com p @ INSURER(S)AFFORDING COVERAGE NAIC# CN1 02832071-Compa-UMB1 0-20- CANTE CANTV INSURER A:National Union Fire Ins Co.of Pittsburgh PA 19445 INSURED INSURER B:AIU Insurance Co 19399 Canteen Vending Services 1716 Camden Ave. INSURER C:ACE Property And Casualty Ins Co 20699 Durham,NC 27704 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-005185847-01 REVISION NUMBER: 1 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY GL1728994 09/30/2020 09/30/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO TED CLAIMS-MADE � OCCUR PREMISES ('a a occurrence) ctcur ence) $ 1,000,000 X SIR:$1,000,000 MED EXP(Any one person) $ X Contractual Liability PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 10,000,000 X POLICY❑ PRO- POLICY ❑ LOC PRODUCTS-COMP/OP AGG $ 5,000,000 OTHER: I $ A AUTOMOBILE LIABILITY CA 4594426(AOS) 09/30/2020 09/30/2021 COEaMBINED accident SINGLE LIMIT $ 2,000,000 A X ANY AUTO CA 4594429(VA) 09/30/2020 09/30/2021 BODILY INJURY(Per person) $ A OWNED SCHEDULED CA 4594427(MA) 09/30/2020 09/30/2021 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS A X HIRED X NON-OWNED CA4594431(Garage Liability) 09/30/2020 09/30/2021 PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Self Insured for Physical Damage $ X UMBRELLA LIAB X OCCUR X00 G27738631 09/30/2020 09/30/2021 EACH OCCURRENCE $ 10,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION WC 045886802(AOS) 09/30/2020 09/30/2021 X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B Y/N WC 045886807(CA) 09/3012020 09/30/2021 2,000,000 ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ B OFFICER/MEMBER EXCLUDED? N/'4 WC 045886803 FL 09/3012020 09/30/2021 (Mandatory in NH) ( ) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 B If yes,describe under WC 045886808(NY) 09/30/2020 09/30/2021 E.L.DISEASE-POLICY LIMIT $ 2,000,000 DESCRIPTION OF OPERATIONS below A Liquor Liability GL1728990 09/30/2020 09/30/2021 Each Common Cause 1,000,000 SIR:$1,000,000 Aggregate 10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hillsborough,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee _lVi av�ao .h1J�K L ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:5EDEB981-591E-4B40-919A-DCDA565AD550 AGENCY CUSTOMER ID: CN102832071 LOC#: Atlanta AC"J?o ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA,INC. Canteen Vending Services 1716 Camden Ave. POLICY NUMBER Durham,NC 27704 CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate Of Liability Insurance Workers Compensation Continued: Carrier:New Hampshire Insurance Company Policy Number:WC 045886804 Effective Date:09/30/2020 Expiration Date:09/30/2021 Policy Covers States of:MA,WI, Stop Gap Coverage:ND,OH,WA,WY. Limit: E.L.Each Accident:$2,000,000 E.L.Disease-Policy:$2,000,000 E.L.Disease Each Employee:$2,000,000 Workers Compensation Continued: Carrier:National Union Fire Ins.Co.of PA Policy Number:XW C6559404 Effective Date:09/30/2020 Expiration Date:09/30/2021 Policy Covers States of:OH(Excess WC) Limit: E.L.Each Accident:$2,000,000 E.L.Disease-Policy:$2,000,000 E.L.Disease Each Employee:$2,000,000 -------------------------------------------------------------------------------------------------------------------------------------------------------------- ADDITIONAL INFORMATION Umbrella Liability policy provides additional limits and follows the Additional Insured and Waiver of Subrogation provision of the above captioned underlying policies as shown,if required by written contract and permitted by law. Workers Compensation Policy#WC045886802(AOS POLICY) Covers the States of: AK,AL,AR,AZ,CO,CT,DC,DE,GA,HI,IA,ID,IL,IN,KS,KY,LA,MD,ME,MI,MN,MO,MS,MT,NC,NE,NH,NJ,NM,NV,OK,OR,PA,RI,SC,SD,TN,TX,UT,VA,VT,WV ACORD 101 (2008/01) ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD