Orange County NC Website
Browse       Search
NlCEAND-01 BHOOVER <br />'`,`°R°~ CERTIFICATE OF LIABILITY INSURANCE °~~`~~°"~"'' <br /> M13/2072 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOE3 NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICA7E OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN TNE ISSUING INSURER(S-, AUTHORIZED <br />REPRESENTATIVE OR PRQDUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: H the certiflcate holder fs an ADDITIONAL INSURED, the pollcy(ies} must be endorsed. If SUBROGATION IS WAIVED, subjest to <br />the terms and conditions of the policy, certain policfes may requlre an endorsement. A statement on this certlfiwte does not confer rights to the <br />certificate holdar in lieu of such endorsement{s). <br />PRODUCER NTACT <br />NAME: <br />Winfred C. HarperAgency <br />1037 3. Main Street PHONE , 336 227-~Z7~ °iX ~; 336 222-9469 <br />PO Box 1867 E'AdA1L <br />AD°~g' <br />Burlington, NC 2721&1867 <br /> INSURER{8 AFFORDINOCOVERql3E NAICA <br /> INSURERA:Ery@ ~~iSU~811CB EXCF18 <br />INSURED <br />. <br />INSURER 8 : <br />Nice 8 Green Flooring Solutlons <br />LLC iNSUr~ c: <br />, <br />1183 University Drive #105-113 MISURER D: <br />Burlington, NC 27215 <br /> INSURER E : <br /> INSURER R : <br />COVERAOES CERTIFICATE Nul1AHER~ a~ns~eN N~~ua~R• <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS7ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY COMTRACT OR OTHER DOCUMENT YVITH RESPECT TO WHIGH THIS <br />CERTlFICATE MAY BE ISSLFED OR MAY PERTAiN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEO HEREIN IS SUBJECT TO ALL TI1E TERMS, <br />EXCLUSIONS AND CONDITIpNS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />wsrs <br />LTR <br />TNPE OF INSURANCE <br />POLICY NU~l9ER ra icv ~ <br />MMlDD/YYYY POLICY EXP <br />IM/DD <br />~~Tg <br /> OENERAL LIA6ILITY EACH OCCURRENCE $ ~~OOQ~00 <br />/4 X CONriIERCWL 6ENERAL LIABILIiY BD 3/7120~ 2 3/7/2013 pREMISES a occurrence 3 1,~a~~~ <br /> CLAIMS-MADE ~ OCCUR MED EXP (My orte pe~son) S 5.~~ <br /> PERSONAL&A~VINJURY i ~,~O,OOO <br /> c~wEw~ AGOC~ca~ S Y.OOO,OOO <br /> GEN'LAGGREGATE LIMRAPPLfES PER: PRODUC73 -COAAP/OP AGG S 2~000,000 <br /> X POLICY PRo- LOC E <br /> A~T OMOHILE LIABILITY a aoa'dmt~ 1,000,~~~ <br />Q X ANYAUTO Q030730727 ~/2~~2 3/712013 BODlLYINJURY(Perpenon) $ <br /> ALLONMED <br />AUTOS SCHEDULED <br />AUTOS BODILYINJURY(Peracddent) S <br /> HIREDAUTOS ~~ ~ED P~~~~ $ <br /> $ <br /> UMBRELLALIAB p~CUR EACH OCCURRENCE S <br /> E%CE3S LIAB ~LqIM$JJIADE A6C,RE~ATE $ <br /> pED RETEIdT1pN $ $ <br /> WORKERS COMPEMSATION <br />AND EMPLOYERS' LtABILITY WC STATU- OTH- <br />~ <br />A ANY PROPRIETOR/PARTNERIEXECUTIVE Y~ N <br />D <br />N/A Q870700668 3R/2012 3/7/2013 E.L EACM ACCIDENT S SOO,O <br /> OFFICER/MEMBEREXCLUDED? <br />(M3~ldat0ly ill NH) E.L DlSEASE - EA EMPLOYE $ SOO~O <br /> If yes, dacribe un~kr <br />DESCRIPTION OF OPERATIONS below <br />E.L OISEASE - POLICY LIMIT <br />S SOO,OO <br /> <br />DE9CRN'TION OF OAERATIONS ! LOCATtOP1S! VEHICLES (Atlach ACORD 101, Ad~tbnal Remsrks 9ehedule, it more space b requlrotl) <br />Certlflcafe Holder is named as an Additanal Insured with res~ct to General Liability and CommeraFal Automobile. <br />Cancellatlon notlce eppUea per Erie form i~ GU-728 attached. <br />GtK f IhIGA 1 t fIUWtK GAIVGtLLA I IUIV <br />County of Orange <br />P.o. Box E781 <br />Hillsborough, NC 27278 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLIClES BE CANCELLED BEFORE <br />THE EXPIRATfON DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVIStONS. <br />REPRESENTA7IVE <br />Cc~ 1988-2010 <br />N. All riahts ~eserved <br />ACORD 25 (2010/05) <br />7he ACORD name and logo are registered marks of ACORD <br />