Orange County NC Website
Browse       Search
ACORO" OP ID: DC <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDfYYYY) <br /> 12/12/11 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les)must be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER 336-227-7458 NNAAMEC Dee Ann M Cob,CIC,CISR x207 <br /> Jennings M.Bryan Insurance PHONE <br /> P.O.Box 1118 336-228-8685 C N, E ;336-227-7458 <br /> AX No): 336-343-1000 <br /> Burlington,NC Bryan II ADDDRESS:dcobb 'ennin smb an.com <br /> Jennings M. Bryan III <br /> CUSTOMER ID e:OEENT-1 <br /> INSURERS AFFORDING COVERAGE NAIC <br /> INSURED OE Enterprises,Inc. INSURERA:Philadelphia Insurance Co <br /> Carolina Shredding Authority INSURER B:United Heartland <br /> 348 Elizabeth Brady Road <br /> Hillsborough,NC 27278 INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ILTR TYPE OF INSURANCE POLICY NUMBER POLICY <br /> MID E MMIDDIYYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY X PHPK438964 06/30/11 06/30/12 PREMISES Ea occurrence $ 100,00 <br /> CLAIMS-MADE F—I OCCUR MED EXP(Any one person) $ 5,00 <br /> A X Professinal E&O PERSONAL&ADV INJURY $ 1,000,00 <br /> A X Employee Benefits GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> POLICY PR of LOC $ <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT <br /> A X ANY AUTO (Ea accident) $ 1,000,00 <br /> PHPK438964 06/30/11 06/30/12 <br /> ALL OWNED AUTOS BODILY INJURY(Per person) $ <br /> BODILY INJURY(Per accident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> X HIRED AUTOS (Per accident) $ <br /> X NON-OWNED AUTOS $ <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,00 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,00 <br /> A PHU B276941 06130!11 06/30/12 <br /> DEDUCTIBLE <br /> X RETENTION $ 10000 $ <br /> WORKERS COMPENSATION WCSTATU- OTH- <br /> AND EMPLOYERS'LIABILITY X TORY LIMITS ER <br /> B ANY PROPRIETORIPARTNERIEXECUTIVE YIN 0400099483 07101 M 1 07/01/12 E.L.EACH ACCIDENT $ 500,00 <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 <br /> A Directors/Officers PHSD432260 06130/11 06/30/12 3,000,00 <br /> A EPLI PHSD432260 06/30/11 06130/12 1,000,00 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101 Additional Remarks Schedule,if more space Is required) <br /> Third Party Crime Bond/Employee Dishonesty$10 000 Limit$500 Deductible <br /> Montgomery Insurance Company,Policy#50644615 1113111 to 11/3112 <br /> Holder is listed as an additional insured <br /> CERTIFICATE HOLDER CANCELLATION <br /> PIEDM21 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Piedmont Food&A THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Processing Center <br /> Orange County,NC AUTHORIZED REPRESENTATIVE <br /> 500 Valley Forge 2 <br /> Hillsborough,NC 27278 <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD <br />