Orange County NC Website
Browse       Search
. 04125/2612 11:60 9199330155 LEE-h90~RE INSURANCE PA6E 02/'03 <br />~yIN' ID: AM <br />~"`~'~'~.°_--12°F CERTIFICATE OF L1ABIL.ITY INSUR DATE{MNUPI)IYYYY) <br />ANCE oar<:E~a~z <br />THIS CERTIFICATE 18 13SUED AS A MATTER OF INFORMAtION ONLY AIVD CONFERS NO RIGiiTS UPON THE CERTIFICATE HOL[113R. THIS <br />C E R T I F f C A T E D ~ E S N O T A F F I R M A T I V E L Y O R N E G A T I V~~, Y A M E N O, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE F'tILICIES <br />BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE 15SUING INSURER(S), /1UTFIC:iR12~D <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFIGATE HOLDER. <br />IMPOR7ANT: If the certl~cate holder Is an ADDfTiONAL INSURED, the polioy(fes) must be endorsed. If SUBRQGATION IS WAIVED, :;iah~~ect to <br />the terms and condltfons of the pollcy, certaln policlas may requlre an endorsement A statement on th;s certlilcate does not confer rlgt t~s to the ~ <br />certificate holder in Hou of such p~a~,sen,e~+re~ <br />PRODIJCQR s~ o-s73~n~ <br />Lee-Moore Insurance Agency I~c <br />P.O. Box 667 <br />West End, NC 27376 <br />Alex Maiolo <br />~"s"~~ Clark Poe Constructlon, inc <br />134 Gra~ger Rd <br />Chapel HIII, NC 27516 <br />X <br />--- • NAIC p . <br />_ ~ 18 9~t13 --.- <br />THIS IS TO CERT~FY THAT TryE POLICIES OF INSURANCE I,ISTCD 6ELOW HAVE BEEN ISSUHD TO fHE INSURED NAMED ABO E~ OR THF_ POLIC'Y:F'C-RlOD <br />INf~ICATED. NOTWITHST~NDING ANY REQUIREMENT, T~RM OR CONpITION OF ANY CONTRACT aR OTHER DOCUMENT WITI•I RESPECT TO WHICIy T111S <br />CERTfFIGATE MAY BE ISSUED OR MAY PER7AIN, THE INSURANCF. AFFORDED BY TI~IE POLICIES D@SCRIBED NEREIN IS SUBJECT TO ALL THF. i'~,RhllS, <br />EXCLUSIONS AND CONDITI~NS OF SUCH PO~(CIF_S. LIMITS SHOWN MAY HAV~ BEEN REDUCED BY PAID CIAIMS. <br />LTR 7YPE Of INSURANCE POUCY NUM9ER. MMI~p~DY Y MM~lpDK LIMITS ~ v <br />QF.NERAL LIA61U1Y <br />Q x COMM[RCIALGENGRAI,LIABILITY X 35963340 ~~~~12 0~,~13 ~^'OCHOCCURRENCE g ,_^T~000~~ <br />PRF,(~A~SE3 Ea~ g $ 'IOO,~ <br />. J c~.aians-nnnor: ^X occuR ----•• <br />MED EXP tAnv enn nnnnM 4 ~~~ Ai <br />OEP!'L AGGRF,pATE LIMIT qppLl£S FER: <br />nuronnoaiLE LIABiu7r <br />ANY AUTO <br />nLl OWNED AUTOS <br />x ~ sCHEDU~ED nuTpg <br />Ia1RFD AUroS <br />NON-OWNF,O AUTOS <br />UMDRBLLA LIq9 OCCUR <br />PaCCEBA I.IAB CIAIMS <br />DEDUCTIRI.E <br />I AND EMPLOYL+RS' LIq9161TY <br />A ANYFRaPRIET[fw~oanrniren <br />E~~: <br />Zto n.: CLARK-3 <br />INSURER(9) AFFORDINO COVBRApE <br />; Auto-0wners Insuranee _ _ <br />E: <br />o2nen2 ~ ozr~a~~a <br />Yj~ I N~ A I I3503B096 ~410'1112 I o4J01/13 <br />L~I <br />D[SCRIPTION OF OPERqrON3 / LOC4'ryONS / V2NICLES (AReeh ACORD 701, AAaltlonel Rmm~rke 3ehedute, If maro apace ~e nppulrod) <br />Certificate Holder is names as an Additionat Insured with respect to General <br />LiablRty and Auto. Cartcellation notlce applies per faX atteched. <br />PEFSONAL 8 ADV INJURY $ <br />GENFRALAGGREQATE ~ <br />PRODUCTS • COMP/OF' AGG $ <br />~ ~ <br />COM61NEq SINGLE uMIT <br />(Eq aecldenl) ~ <br />BODILY INJURY (Per petton) q <br />BOD~LY IN,IURY (Per acc~dnm) <br />PRpPER'IY DnnMCiE <br />fPer omlaanq <br />_ S <br />~ <br />.. ~ <br />. __ '_~_ <br />EACH OCCURRENCC- 5 <br />AGGREC+ATE $ <br />_ __ '~ <br />e•L. 4AGFi ACCID~NT $ <br />F,.L. ~ISE/wF • EA EMPLOYEE fl~ <br />E t_ o~c~e~e _ ani irv ~ uem a <br />1,D00 <br />~,000 <br />2„000 <br />500, <br />--- ~~ fl~~l <br />'U ~D0.1 <br />ORANGE1 ""'-" <br />SHOULD ANY OF THE ABOVE DEgCRBED pOLICIES 6E CANCELLEO 9EPORE <br />Orange County THE EXPIRATION DATE THEREOF, NOTICE WI~~ BE DELIVEftE.L'i IN <br />Asset Management Services AecoaoANCe w~rN rHE Po~icY PROVisioNS. <br />West Margaret Lane '- <br />Hillsborough, NC 27278 AUTHORIZED R~RE9f,NfATpi~ `~ <br />Alex Maiolo~ <br />91988-2 PORATION. All rights resoi~red. <br />ACORD 26 (2009/09) The ACORD name and logo ar~ registered marks of ACORD <br />