Orange County NC Website
~"~ <br />ECW <br />'`~~!rO~ CERTIFICATE OF LIABILITY INSURANCE ROOZ 02TE27/D2O1'2 <br />THIS CERTIFICATEIS 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 INSURERIS), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder is an ADDITIONALINSURED,the policylies) must be endorsed. If SUBROGATIONIS 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 endorsementls). <br />PRODUCER <br /> <br />THOMAS RUTHERFO CONTACT <br />NAME: <br />ORD INC/PHS <br />731978 P: (866) 467-8730 F <br />(877 <br />53 Iq/CNNo eXC: (866) 467-8730 in"ic,rvo~: (877) 538-8526 <br />: <br />) <br />8-8526 <br />P~ B~X 29611 E-MAIL <br />ADDRESS: <br /> <br />CHARLOTTE NC 2 8 2 2 9 PRODUCER <br />C STOMER ID #: <br /> INSURERIS) AFFORDING COVERAGE NAIC N <br />/NSURED INSURER A: S2I1t1I121 I11S CO LTD <br />NELLO' S ITALY <br />LLC INSURER B: <br />, <br />P~ B~X 80441 INSURERC: <br />RALEIGH NC 27623 INSURERD: <br /> INSURER E : <br /> INSURER F : <br />cuvtrs,q~ts CERTIFICATE NUMBER: RFVisinni n~i innRFa• <br />THIS IS TO CERTIFY THAT THE POIICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POIICY 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 HEREfN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />/NSR <br />LTR TYPE OF /NSURANCE <br />/NSR <br />WVD <br />POL/CY NUMBfR POL/CY EFF <br />/MM/DD/YYYY1 POL/CY EXP <br />(MM/DD/YYYY/ <br />L/M/TS <br /> GENER.4L L/ABlL?Y EACH OCCURRENCE S 2~ O O O O O O <br /> COMMERCIAL GENERAL LIABILITY PREMISES IEa occurrence) S 1 i O O O~ O O O <br />A CLAIMS-MADE ~ OCCUR MED EXP (Any one person) 6 1 O~ O O O <br /> X General Liab X 14 SBM ZF3455 02~18~2012 02~18/2013 PERSONAL&ADVINJURY S 2~ ~~~~ ~0~ <br /> <br /> GENERAL AGGREGATE S 4~ O O O~ O O O <br /> <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 4~ O O O~ O O O <br /> POLICV ~ PR~ ~ LOC S <br /> AUT OMOB/LE L/AB/L/TY COMBINED SINGLE LIMIT <br />S <br /> ANY AUTO (Ea accident) 2~ ~ ~ ~~ ~ ~ ~ <br /> <br />ALL OWNED AUTOS BODILV INJURV ~Per person) S <br /> <br />SCHEDULED AUTOS BODILV INJURY (Per accident) S <br />A <br />14 SBM ZF3455 <br />oa/ia/zoiz <br />oa/is/zoia PROPEflTY DAMAGE <br />S <br /> X HIREDAUTOS (Peraccident) <br /> X NON-OWNED AUTOS S <br /> S <br /> UMBRELLA UAB OCCUR <br />EACH OCCURRENCE <br />S <br /> EXCESSL/AB CLAIMS-MADE <br />AGGREGATE <br />S <br /> DEDUCTIBLE g <br /> <br /> RETENTION S 5 <br /> WORKERS COMPENSAT/ON WC STATU- OTH- <br /> AND EMPLOYERS' L/AB/L?Y TORY LIMITS ER <br /> Y! N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBEREXCLUDEDt ^ <br />N~A <br />E.L. EACH ACCIDENT <br />S <br /> lMandatory m NHJ <br />E.L. DISEASE - EA EMPLOYE <br />S <br /> If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br /> <br />DESCR/PT/ON OF OP£R4T/ONS / LOCAT/ONS / VEH/CLES /Attach ACORD 107, Addi[rone! RemaAcs Schedu/e, i/ more space is requbedl <br />Those usual to the Insured's Operations. Orange County, NC and Piedmont Food <br />and Agricultural Processing Center are listed as additional insured on the <br />business liability per business liability form 550008. <br />CERTIFICATE HOLDER CANCELLATION <br />Orange County, NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />and Piedmont FOOC~ BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />and Agricultural Processing Center DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />5 0 0 VALLEY FORGE RD AUTHOR/ZED REPRESENTAT/VE 4 <br />HILLSBOROUGH, NC 27278 ~~_ ~q~(.~,~,.~- <br />° 1988-2009 ACORD CORPORATION. A~I rights reserved. <br />ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />