Orange County NC Website
Browse       Search
Ju•1 1 S OS 03: 34p <br />p. i <br />ACORV_ CERTIFICATE OF LIABILITY INSURANCE OP ID OATC(MMIDDM/V`n <br />LAWRE-1 07 15 05 <br />,PRODUCER 7FIIS CERTIFICATE IS ISSUEO AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />~ Thompson-Allen, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P . O . Box 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Roxboro NC 27573 <br />Phone:336-599-2175 Faxz336-599-6932 <br />INSURCR <br />Toamiy Lawrence Electrical <br />P.O. Box 64 <br />Roxboro NC 7573 <br />INSURERS AFFORDING COVERAGE ~ NAIC # <br />INSUKLKA: r[iaaiaauri aa.ur...r.. Qauy.nr <br />INSUKCK B: r,.laei.:uet r......1 ry [empauy <br />INSUKCK C: <br />INSURCR D: <br />INSURCR C: <br />,.w.i~w ~ncc <br />TI IC POLICICS Of INSURANCC LISTCD DCLOW FIAVC OCCN ISSUCD~U (HL IN5UKkU NAMbU ANOVk FOK IHk I'OUCV vFwlOU INi)ICATFO. nK)TWIT/L';TANDINC, <br />ANY RCUUIttLMLN i. I LKM UK GUNUn IUN Uf ANr CUN I eiAC r OH ATHI'rt fK7CUMCNT WITI I RC ;PCCT TO W I IICI l TI tlS CCRTI~ICATC MAY DC Iw°UCD OR <br />MAY PCRTAIN, TI IL IN ;11R/WCC /1rt•ORDCD DY TNC POLIGIC5 DCSGRIBLU HL•KtIN 15 5U-1JtC I 10 ALL 1'Ht ~ffYtM$, PXCI U$IONS ANO CANDITIONS Af 311C11 <br />PUUGiI$. A<~C.Ri-14A7F l IMII'S SHOWN MAY I INVC DCCN RCDUCCD DY rAIO CLAIMS. <br />w5R WOO'Lf "' POLICY FPFECTNE POLICY EYPIRATION <br />1 TR YNSRCdI TYPE Of INSURANCC POLICY NUMBER DATE MMIDD/rr DA ~F MMIIfO)Tr <br />~...- LIMITS <br />~ GENERALLIABILRY CACHOt:I:URNLNGL" S SOO, OOO <br /> <br />COMMCRCIALCCNCRALLIADILITY CPP 0666924 08/16/Oh 08/16/05 I <br />A S X UAMAi.:p I U NkN 11: U <br />I'KLMISL;i(l.axwronco) <br />E lOO, OOO <br />l <br />CLAIM : M/~DC I $ I OCCUR Mfr) fXF' (My onr. Iwaelxl) S $ , O O O <br /> NI R.ji7NAl R AI)V INJURY S 5O O , OOO <br />... ., ... <br />Gt:NI~.KAI AC:C:NFC.AIF'. ... <br />S 1, OQO, 00~ <br />GCN'L AGGKLGA r t LIMI I AF'FM o-8 rl=k• PNUUUG 1 S- GUMI+IUI+ AGC: S 1, 0 0 0, O O 0 <br />POLICY PHU- <br />JCGT LUG <br /> <br /> AUT OMODILC LIADLL.ITY COMDINLD SINGLC LIMIT <br />s 1, 000, 000 <br />A 3C ANY AU TO CPA 0666924 08/16/04 08/16/05 ~EgiCO<Itl1'~ <br /> ALL UWNC:U AU 1 VS FI()1')II Y INJURY <br />5 . <br /> 5GI ICDULCD AUTOS (vqr porsan- <br />-... <br /> ` HIRf.D AUTOS DUDILr INJUNY f <br /> (r~+/3CtldBM) <br /> NVN-VWNI•(1 Al1TAi <br /> rROrrrITY DAMAt:C S <br /> <br /> GARAGE LIABILITY I AUTO ONLY-CAAGCIDCNi S <br /> aNV nUTO O I FiFNI TITAN CA ACC b <br /> AU I V UNI Y: AGG S <br /> Ej(CE$$/VMeRELLA uABILITY L:AGH U(:GUNItFN(:F S 5 , O O O , OOO <br />~, 7L I occuR ~ I CLAIM$MAIII~ CCC 4443872 08/16/04 08/16/05 AOC;RCCrAIL s <br /> s <br /> r>~ nucnDLC s _ <br /> X Kl•11-N 1'IAN S s <br /> WORKERS COMPENSATION AND _ <br />Y I User I IMI'rS r li <br /> <br />B EMPLOVENS' uADILITY <br />wc8966267-08 <br />01/01/05 <br />01/01/06 <br />I,.L.IAr,HnccIDCNT <br />- <br />s 100, 000 <br /> ANr FKUI'IiIFTOwPARTNf.R/Cx[CUTIVC <br />Or'PIGLWMLMU~Ii h><Ct uuCD'r C.L. UISLA51c- FA FMNI OYf i <br />~ <br />~~ ; l OO , OOO <br /> If yna: Anunlxe undo <br />;~MF•<~IAI I+fll)VIRInN.i lleluw IMI Y <br />I <br />C.L. DISCASC - 1'OUGY s 5 O O , O O O <br /> OTHtR <br />. <br />OCSCRIDTION OF OPERAnON51 LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY [NDORSENIENT /SPECIAL PROVISIONS <br />Orange County named as Additional Insured for general liability coverage. <br />JOB: Efland Cheeks & Smith Middle School Ballfielda <br />l: GK 7 RI~,A I C nV~uc~c <br />Orange County <br />Attn: Pam Jones <br />239 East Kiag Streee <br />Hillsborough NC 27278 <br />O~GEC SNOULO qNr OF THE ABOVE DCSCRID[O POLICIES BE CANCELLED BEFORE THE EXPIRATK)N <br />DATE TNEREOF, THE ISSUING INSURCR WILL MNL 3 O DAYS WFdTTCN <br />NOTICE TO THE CpITIFlGATE IWLDCR NAIiCD TO THE LEFT, BUT PA4URE TO DO SO SN/LLL <br />IMPOSE NO OBLIGATION OR LIA®IIJTY Of ANY KIND UPON THE INSURER, ITS AG9NT$ OR <br />R[PRESENTATi1lES. <br />' 1 }) . <br />X498 <br />AGUKV L7 (YVV~)va! <br />