|
AC�JRDTx� CERTIFICATE OF LIABILITY INSURANCE DATE ODlYY)
<br /> ` 10/4/2013
<br /> _:.._..........__........
<br /> . ___ _
<br /> THIS CERTIFICATE IS!SSVED AS A MATTER OF INFORMATT<Nd ONLY ANp CONFERS NO RIGHTS UPON THE CERTIrICATE HOLDER 'PHIS CERTIFICATE DOES NOT AFFIRMATIVELY OR
<br /> NEGATIVELY AMEND.EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POf_I('dES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN
<br /> _THEISSUING 1 •2 S).AUTfiORllF..D REPRESENTARVE OR PRODUCER.ANp THE CERTIFICATE HOLDER '
<br /> IMPORTANT-If die certificate holder is an ADDITIONAL INSURED.the AA(IQy(ies)must he endorsed.if SUBROGATION IS WAIVED,subject to the terms and condifions of the policy,cect&n nogne9 sr:ay
<br /> reaurre an t ndarsemanL A Shat mnent on this celtilidate does not conler_1 Is o the c-.ertificate holder n keu of such endorsernrnt(s)
<br /> PRODUCER CONTACT
<br /> NEGLEY ASSOCIATES NAME'
<br /> FAX
<br /> 103 Eisenhower Parkway,Suite 101 PHONE
<br /> Roseland,NJ 07068 (A/C,No,E)a): 1 ) tnrc,No): ( )
<br /> E-MAIL
<br /> (973)830-8500 ADDRESS:
<br /> �..._._.._. - - ,^`�^�• _ INSUR_ERSAFFOREIWI COVERAGE. _ NAICII _ •_
<br /> {INSURED INSURER A. Scottsdale Insurance Company
<br /> Club Nova Community,Inc. INSURER B:Liberty Mutuai Insurance Company
<br /> P.O,Box 1346 INSURER C Travelers Indemnity Co.of CT
<br /> Carrboro,NC 27510 —
<br /> INSURER D.
<br /> INSURER E
<br /> INSURER F'
<br /> COVERAGES CERTIFICATE NUMBER: _ _ .. _ REVISIONNI7NlBRt_._ _
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
<br /> NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY
<br /> PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AL4 THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN
<br /> MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR ADDL SUBR POLICY EFF POLICY ExP
<br /> L7R�—_ _ TYPE OP INSURANCE INSR MD ..POLICY NUMBER MMIDDIYY,- �MMIOOIYYYY __,_-_,�,•__,_,�, t:IMITS M _,-•
<br /> A GENERAL LIABILITY OPS0062146 05/1312013 05/1312014 EACH OCCURRENCE s1,000,000-
<br /> MCOMMERCIAL GENERAL DASILITY DAMAGE TO RENTED $ 300,000
<br /> 1@29CLAIMS-MADE ❑OCCUR 1] P lMISES NEa ocourren-y rye
<br /> I 1_) M.[0 EXP(Airy one person) $ 5,000
<br /> PERSONAL 8 AOV.INJU:RY_... - S 1,000.000
<br /> GEN L AGGREGATE LIMIT APPLIES P_R: OCNERtiL AGGREGATE__ k S 3,000,000
<br /> PRODUCTS-•COMP'OP,AOG S 3,000,000 .
<br /> NPOLICY []PROJECT ULOC �'""�`-"'�•-
<br /> S
<br /> ......,._......................._..s_.:_-•-._»a..__._.------------
<br /> ...._._....._�..-.._..._.,.............._....:....._.__._.._._-_...._ _ ._.....«.-- - .._._...__...__.::__.-.,...,,
<br /> C AUTOMOBILE LIABILITY ❑ 0 BA-0428R636- 05/1312013 ',05/13/2014 COMBINED SINGLE LIMIT S 1,000,000
<br /> ❑ANY AUTO 13 .BODILY INJURY(Per Person) $ _
<br /> ❑ALL OWNED 2]SCHEDULED BODILY INJURY(Per Accident) S
<br /> AUTOS AUTOS
<br /> ❑HIRED AUTOS ❑NON-OWNED PROPERTY DAh1AGE $ )
<br /> AUTOS Pc{ CC'
<br /> ❑UMBRELLA UAB []OCCUR 11 ❑ EACH Uf.'CIiRRENCE $
<br /> (]EXCESS LIAB C]CLAIMS-MADE
<br /> ❑OED (]RETENTION S $
<br /> El B WORKERS COMPENSATION WC1-641- 05/13/2013 05/13/2014 WIC STATU- )]OTHER
<br /> AND EMPLOYERS'LIABILITY YIN .—..TORY LIMITS——,
<br /> ANY PROPRIETOR/PARTNER/EXEC d NIA O 438860-013 E,L EACH ACCIDONT"
<br /> OFFICErMEMBER EXCLUDED? —`
<br /> (Mandatory In NH) E.L DISEASE-EACH $500,000
<br /> dyes,doscribe under EMPLOYEE S
<br /> DESCRIPTION OF OPERATIONS below _ _ _ E.L DISEASE-POLICY LIMIT $500,000
<br /> A Professional Liability
<br /> I PS0062146 05/13/2013 05/13/2014 ^1,000,106 Each Claim
<br /> (] $ ~
<br /> [] 3,000,000 Aggregate
<br /> DESCRIPTION OF OPFRATION&LOCAT10NSIVEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more Space I5 required)
<br /> Certificate Holder is added as Additional Insured under General and Auto Liability, but only with respects to operations of the
<br /> Named Insured.
<br /> l..._:
<br /> CERTIFICATE HDLDBFY i»A_NCELLATt—OV�_
<br /> County of Orange,a political Subdivision of the State Of North Carolina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE
<br /> 240 South Cameron Street CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
<br /> Hillsborough,NC 27278 NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE
<br /> POLICY PROVISIONS.
<br /> A�UHF 0_REL SE", T1�7
<br /> Cop1�i>ht.1468-2010kC'1�t2E)t::Ct.Etl+Ot2AiION.AII TtXllts icseNtei).
<br /> ACORO 25(2010/05) The ACORD name and logo are registered marks of ACORD
<br />
|