Orange County NC Website
Al°°� DATE CERTIFICATE OF LIABILITY INSURANCE 10/02/2012' <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 endomement(s). <br /> PRODUCER <br /> 122 NT CT T Carla Moore <br /> ME: <br /> COLONIAL INSURANCE AGENCY PHONE {919} 732_2192 FAX ,(414) 732-2142 <br /> P.O. BOX 490 Mss:Carla@ colonial-agency.com <br /> INSURE NS)AFFORDING COVERAGE NAIC q <br /> HILLSBOROUGH NC 27278- INSURERA:TRAVELERS INSURANCE COMPANY 25674 <br /> INSURED A S L INC DBA ALL SEASONS LANDSCAPES INSURER B: <br /> 214 PHELPS RD INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> HILLSBOROUGH NC 27278— 1 INSURERF: <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 /> IN SR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY-NUMBER MM/ MMIDD <br /> A, GENERAL LIABILITY -680-2632M25-1-TIL-12 4/30/2012 4/30/2013 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCt4L GENERAL LIABILITY J / / / PREMISES(Eaoccu $ 300,000 <br /> CLAIMS-MADE I X1 OCCUR / / / / MEDEXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> N'L AGGREGATE LIMIT APPLIES PER: / / / / PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> GE <br /> POLICY PRO. LOC J J J J PRDCV $ 1,000,000 <br /> .JrCT 630M061-12 4/30/2012 4/30/2013 SINGLE LIMIT <br /> A AUTOMOBILE LIABILITY Me accident) 11000,000 <br /> X ANY AUTO / / / / BODILY INJURY(Per person) $ <br /> ALLOSMED SCHEDULED / / 1 J BODILYINJURY(Per amident) $ <br /> [J NON-OWNED P PERK DAMAGE $ <br /> HIREDAUTOS AUTOS (Per cads <br /> I <br /> J J I 1 $ <br /> A X UMBRELLALIAB X OCCUR UP9604Y68A 4/30/2012 4/30/2013 EACH OCCURRENCE - $ 1,000,000 <br /> EXCESS LIAR CLAIMS-MACE AGGREGATE $......,, 1,000,000 <br /> DED I I RETENTION$ $ <br /> A WORKERS COMPENSATION H UB 263M33112 4/30/2012 4/30/2013 WCSTATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN <br /> ANY PROPRIETORIPARTNER+EXECUTIVE N/A E.L.EACH ACCIDENT $ 500,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory In NH) / / / / E.L.DISEASE-EA EMPLOYEE $ 500,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below / / / / E.L.DISEASE-POLICY LIMIT $ 500,000 <br /> PWRPC <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Orange County 200 S Cameron St PO Box 8181 Hillsborough NC 27278 is additional insured with respects to <br /> General Liability by written contract. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange Co. Parks 5 Recreation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED M <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 S Cameron St AUTHORIZED REPRESENTATIVE <br /> PO Box 8181 ' <br /> Hillsborough NC 27278— , <br /> ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025(201006101 The ACORD name and logo are registered marks of ACORD <br />