Orange County NC Website
® DATE(MMIDD/YYYY) <br /> A� CERTIFICATE OF LIABILITY INSURANCE <br /> 07/17/2013 <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((es) 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 CNgM A' Amy H.Paschal <br /> Ken B Lawson Jr. .919-846-2090 ext 105 _FAX/C No:919-846-2438 <br /> dba Lawson Insurance Group EMAIL s aschaa nationwide.com <br /> 6512-101 Six Forks Rd. INSURER(S) AFFORDING COVERAGE NAIC# <br /> Raleigh,NC 27615 INSURERA: Nationwide Mutual Insurance Company <br /> INSURED INSURER B: EastGUARD Insurance Company <br /> ProNet Systems,Inc INSURER C: Pro ressive Southeastern Ins Company <br /> 3200 Glen Royal Road INSURER D: <br /> Suite 107 INSURERE: <br /> Raleigh,NC 27617 INSURER F: <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 /> INS TYPE OF INSURANCE ADDLSUBR POLICY NUMBER POLICY OFF POU D EXP LIMITS <br /> - . GENERAL LIABILITY ACP2252994383 0212212013 0212212014 EACH OCCURRENCE $1.000.000 <br /> DAMAGE TO RENTED <br /> X COMMERCIAL GENERAL LIABILITY $100,000 <br /> CLAIMS-MADE �OCCUR MED EXP one on $5,000 <br /> X Contractual Liability PERSONAL&ADV INJURY $1,000,000 <br /> X I Contractors Enhancement GENERAL AGGREGATE s2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 <br /> POLICY X PRO LOC $ <br /> AUTOMOBILE LIABILITY 07864851-2 3/01/201303/01/2014 COMBINED SINGLEUMIT 1000000 <br /> C ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> X AUTOS AUTOS <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $AUTOS r <br /> X UMBRELLA LIAO X OCCUR ACP2252994383 2/22/2013 02/22/2014 EACH OCCURRENCE s4,000,000 <br /> A RXEXCES S UAB CLAIMS-MADE AGGREGATE $4 000 000 <br /> ED I X I RETENTION SNone $ <br /> woRICERS coMPENSAnoN pRWC119466 4103/2013 04/03/2014 X WC 3Tim 'R <br /> AND EMPLOYERS'LIABILITY <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE a NIA A E.L.EACH ACCIDENT $500,000 <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000 <br /> (Mandatory in NH) <br /> if y�describe under E.L.DISEASE-POLICY LIMIT $500,000 <br /> DESCRIPTION OF OPERATIONS below <br /> A Business Services Bond 7900388862 7/11/2013 07/11/2014 $50,000.Bond Limit <br /> 3rd Pa <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace is requlred) <br /> Orange County is Included as additional insured where applicable per Contractors Enhancement Endorsement CG 72 88 attached. <br /> Waiver of Subrogation applies and is noted on the attached CG 7288. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> P.O.BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Hillsborough,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ATTN: Tammy Comar AUTHORIZED REPRESENTA <br /> E-Mail: tcomar@orangecountync.gov <br /> E-Mail: a ronets stemsnc.com <br /> >a 1 88-2010 CORD CORPORATION. All rights reserved. <br /> �eC� �.�L ACORD name and logo are registerc ed marks of ACORD <br /> ACORD 25(2010/05) r 1 ��� ✓ <br />