Orange County NC Website
Fm:Hub International Midwest To:FW: Spay-Neuter Assistance Program Policy 83WB (19199182393) 11:29 04/26/13 EST PS 3-4 <br /> Client#:22189 SPAYNEUT <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE FATE <br /> 041262013YY) <br /> 04/26/2013 <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 poiicy(les)must be endorsed,if SUBROGATION 13 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 CO E:ACT <br /> NA <br /> AVMA PLIT Business Insurance P c, 800-228-7548 866-229-3296 <br /> Hub International Midwest Limited &MAIL Ext. ac No <br /> 55 East Jackson Boulevard,Ste 14B ADDRESS: <br /> Chicago,IL 60604 INSURER(S)AFFORDING COVERAGE NAICp <br /> INSURER A:Hartford Insurance Group 29424 <br /> INSURED Spay-Neuter Assistance Program INSURERS:TWIn City Fire Insurance Co. 29459 <br /> of North Carolina INSURER C: <br /> P.O.Box 278 INSURER D: <br /> New Hill,INC 27562 INSURER E: <br /> 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 1S 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 INSURANCE ADDL SUER POLICY EFF POLICY EXP <br /> LTR INSR WVD POLICY NUMBER MIDD/YYYY MM/DD/YY LIMITS <br /> A GENERAL LIABILITY X 83SBWRW6808 1118!2013 01/18/2014 EACH OCCURRENCE _ $2000000 <br /> X COMMERCIAL GENERAL LIABILITY M Ee acurren_e 000,000 <br /> CLAIMS-MADE N OCCUR MED EXP(Any one person) $10,000 <br /> PERSONAL$ADV INJURY s2,000,000 <br /> GENERAL AGGREGATE s4,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $4000000 <br /> POLICY JE� LOC $ <br /> A AUTOMOBILE LIABILITY 83UEGRZ5928 111812013 01/18/201 COMBINED)SINGLE LIMIT <br /> COMBINED $1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE <br /> AUTOS Per accident $ <br /> E <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> B WORKERS COMPENSATION 83WBGPA3772 D610612013 0610612014 X WC STATu- ETH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT 1$500,000 <br /> OFFICERIMEMBER EXCLUDED? � N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEEI$500,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) <br /> Certificate Holder is listed as an Additional Insured as their interests may appear with <br /> respects to the General Liability. <br /> Loc#1-6588 BEAVER CREEK RD;NEW HILL,NC <br /> (See Attached Descriptions) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County Risk Manager SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> P.O.BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough,NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2010 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2010!05) 1 of 2 The ACORD name and logo are registered marks of ACORD <br /> #S722375/M722374 M004 <br />