Orange County NC Website
' * DATE(MM/DDNYYY) <br /> ACOR© CERTIFICATE OF LIABILITY INSURANCE ,/10/2014 <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 Phone: (952)944-2929 CONTACT Jane Doerfler <br /> Fax: (952)944-3091 NAME: <br /> Horizon Agency,Inc. =!N 0.Ext: (952)914-7131 C <br /> IX <br /> No): (952)944-3091 <br /> 6500 City West Pkwy#100 ADDRESS: jape @horizonagency.com <br /> Eden Prairie,Minnesota 55344 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A: Federal Insurance Company 20281 <br /> INSURED INSURER B: Executive Risk Indemnity Inc. 35181 <br /> Springsted Incorporated,Springsted Investment Advisors,Inc. INSURER C: <br /> 380 Jackson Street#300 <br /> INSURER D <br /> St.Paul,MN 55101 <br /> INSURER E <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 3812 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY <br /> GENERAL LIABILITY 35342568 EACH OCCURRENCE $ 1,000,000 <br /> 8/11/2013 8/11/2014 DAMAGE TO RENTED <br /> A ✓ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 1,000,000 <br /> CLAIMS-MADE OCCUR MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000 000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> ✓ POLICY PRO LOC $ <br /> A AUTOMOBILE LIABILITY 73234006 8/11/2013 8/11/2014 COMBINED SINGLE LIMIT 1,000,000 <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> I/ HIRED AUTOS ✓ NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS Per accident <br /> ✓ <br /> UMBRELLA LIAB ✓ OCCUR 79764838 8/11/2013 8/11/2014 EACH OCCURRENCE $ 2,000,000 <br /> A EXCESS LIAB <br /> CLAIMS-MADE AGGREGATE $ 2,000,000 <br /> DED I ✓I RETENTION$ 0 $ <br /> WORKERS COMPENSATION TATU- TH- <br /> A AND EMPLOYERS'LIABILITY YIN 71646620 8/11/2013 8/11/2014 ✓ T R MI R 500,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? a NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 <br /> If yes,describe under 500,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> B Errors&Omissions 82079210 1/14/2014 1/14/2015 Each Claim 2,000,000 <br /> $25,000 Deductible <br /> Ae¢re¢ate 2,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Holder's Nature of Interest:Certificate Holder SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g ty ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Ms.Donna Baker,Orange County Clerk <br /> 200 South Cameron Street AUTHORIZED REPRESENTATIVE <br /> P.O.Box 8181 <br /> Hillsborough,NC 27278 . <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />