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HomeMy WebLinkAbout2026-073-E-Cooperative Extension-Meals on Wheels Orange County-Outside Agency FundingDocusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F 2/26/2026 3/2/2026 Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F 2/27/2026 3/2/2026 3/2/2026 3/2/2026 Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Executive Director 2/26/2026 Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? INSR ADDL SUBRLTRINSDWVD PRODUCER CONTACTNAME: FAXPHONE(A/C, No):(A/C, No, Ext): E-MAILADDRESS: INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) AUTOMOBILE LIABILITY UMBRELLA LIAB EXCESS LIAB WORKERS COMPENSATIONAND EMPLOYERS' LIABILITY DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) AUTHORIZED REPRESENTATIVE EACH OCCURRENCE $ DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $ PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT OTHER:$ COMBINED SINGLE LIMIT $(Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident) $ OCCUR EACH OCCURRENCE CLAIMS-MADE AGGREGATE $ DED RETENTION $ PER OTH-STATUTE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below INSURER(S) AFFORDING COVERAGE NAIC # COMMERCIAL GENERAL LIABILITY Y / N N / A (Mandatory in NH) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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. 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). COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: CERTIFICATE HOLDER CANCELLATION © 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03) CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) $ $ $ $ $ The ACORD name and logo are registered marks of ACORD 2/24/2026 (703) 778-7304 10023 Chapel Hill-Carrboro Meals on Wheels dba Meals on Wheels Orange County, NC PO Box 2102 Chapel Hill, NC 27515 30104 10510 31194 A 1,000,000 X 202536882 7/1/2025 7/1/2026 500,000 20,000 1,000,000 3,000,000 3,000,000 1,000,000A 202536882 7/1/2025 7/1/2026 B 6S60UB0G11045223 7/1/2025 7/1/2026 500,000N500,000 500,000 C Directors & Officers DCP1231894P13 7/3/2025 Limit 1,000,000 D Cyber Liability 107079935 4/4/2025 4/4/2026 Limit 1,000,000 Orange County, its officers, agents and employees are designated as additional insured with respect to the general liability insurance policy when required by written contract. Orange County, NC 113 Mayo St P.O. Box 8181 Hillsborough, NC 27278 CHAPHIL-05 NALAM1 Acrisure East Insurance Services, LLC3 Sylvan Way Suite 200Parsippany, NJ 07054 Nayab Alam nalam@acrisure.com Alliance of Nonprofits for Insurance, Risk Retention Group, Inc. Hartford Underwriters Insurance Company Carolina Casualty Insurance Company Travelers Casualty and Surety Company of America X 7/3/2026 X X X X X Docusign Envelope ID: 59E86970-2419-482B-B075-7E99EA30456F