Orange County NC Website
A� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) <br /> 10/25/2013 <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(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 NAME:C7 Sammy Anderson, CPCU, ARM <br /> Fountain, Roberson, Anderson PHONE (252)823-2416 C. <br /> C No:(252)823-2925 <br /> P.O. Box 338 h-MAUL <br /> 119 East St. James Street INSURE S AFFORDINGCOVERAGE_ NAIC# <br /> Tarboro NC 27886 INSURERAErle Insurance Com an <br /> INSURED <br /> INSURER B <br /> Archaeological Consultants Of The Carolinas, INSURERC: <br /> 121 First Street INSURERD: <br /> INSURER E: <br /> Clayton NC 27520 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER-CL1381400532 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 <br /> L7R TYPE OF INSURANCE POLICY NUMBER MMOILIDDY� MM UDY/YYYY LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO R NTED <br /> PEEMISES(Ea occurrence) $ 1,000,000 <br /> A =CLAIMS-MADE a OCCUR X D441350483 /13/2013 /13/2014 MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> X I POLICY PRO- LOC $ <br /> AUTOMOBILE LIABILITY (Ea aOMBBIINdEDtSINGLE LIMIT 11000,000 <br /> A ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED 081230445 /12/2013 /12/2014 <br /> AUTOS AUTOS X BODILY INJURY(Per accident) $ <br /> NON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS Per accident $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LEAS HCLAIMS-MADE AGGREGATE $ <br /> DIED I I RETENTION$ $ <br /> WORKERS COMPENSATION X WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARrNER/EXECUTIVE T[::] N E.L.EACH ACCIDENT $ 100,000 <br /> A OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) 923000486 /30/2013 /30/2014 E.L.DISEASE-EA EMPLOYE $ 100,000 <br /> If yes,desaibe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H more space is required) <br /> Orange County is named as additional insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> j ethompson@ oragecountync.g SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 131 W. Margaret Lane <br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025 r9mnnst m The Annion nama and Inn^ern ranic#o A mnrirc^f Af'nPn <br />