Orange County NC Website
Browse       Search
OP ID:EL <br /> CERTIFICATE OF LIABILITY INSURANCE F DAT 07105D/YYYY) <br /> 07105!12 <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(ies) 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 CONTACT <br /> PRODUCER <br /> Corporation AA 919-469-2473 PHONE Erin Lunsford FAx <br /> 4325 Lake Boone Trail 919-467-4987 .919-469-2473 Arc No):919-467 4987 <br /> Suite 200 E-MAIL <br /> Raleigh,NC 27607 AROpU� lunsford trisure.com <br /> Alphin&Associates, LLC o SOUT-21 <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED Southern Piping Company INSURERA:Union Insurance Company 25844 <br /> dba SPC INSURER B:Hanover Insurance Company <br /> Kim Holder <br /> 7500 Precision Dr INSURER C: <br /> Raleigh,NC 27617 INSURER D: <br /> INSURER E: <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 /> INSR TypE OF 3NSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS <br /> LTR POLIG NUMBER <br /> GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY X CPA0126609 12/01/11 12/01/12 PREMISES Ea occurrence $ 500,00 <br /> CLAIMS-MADE I I OCCUR MED EXP(Anyone person) S_ 10,00 <br /> X Contractual Liab PERSONAL&ADV INJURY S 1,000,00 <br /> X XC&U Included GENERAL AGGREGATE S 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,00 <br /> POLICY - PRO- LOC Emp Ben. S 1,000,00 <br /> AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 1,000,00 <br /> A X ANY AUTO CAA0126608 12/01/11 12/01/12 (Ea accident) <br /> BODILY INJURY(Per person) S <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Per accident) S <br /> SCHEDULED AUTOS COMP/COLLISION APPLIE -- <br /> PROPERTY DAMAGE $ <br /> X HIRED AUTOS VEHICLES 2002 AND NEW (Per accident) <br /> X NON-OWNED AUTOS $ <br /> S <br /> X. UMBRELLA LIAB <br /> _...X_._OCCUR — _ _._— __--. _----- ...__ .__ _._ .. __.. - EACHOCCURRENCE --.. . .5. _......--10,000,00 <br /> A X EXCESS LIAB CLAIMS-MADE AGGREGATE S 10,000,00 <br /> CPA0126609 12/01/11 12/01/12 <br /> DEDUCTIBLE EXCESS S <br /> X RETENTION 0 Umbrella $ 11,000,00 <br /> WORKERS COMPENSATION <br /> X TORY TA ITS OER <br /> AND EMPLOYERS'LIABILITY <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE Y� NIA <br /> WCA012692510 12/01/11 12/01/12 E,L,EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,00 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,00 <br /> B Leased&Rented IHR9366475 12101111 12101/12 Limit 250,00 <br /> Equipment I IDed 1,00 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> RE:Sportsplex Dectron <br /> County of Orange is named as additional insured under general and automobile <br /> liability If required by written contract. Cancellation provision applies. <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORA8181 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Count Of Orange THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Y g ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Financial Services <br /> P 0 BOX 8181 AUTHORIZED REPRESENTATIVE <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 />