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��•�1 EFLAN-1 OP ID:DP <br /> ACURO� DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 06/05/2013 <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 Phone:919-755-1401 CONTACT <br /> VFIS of North Carolina NAME: <br /> P.O.Box 12825 Fax:919-755-1125 AICNNo Ext: FAX No): <br /> Raleigh,NC 27605 ADDRESS, <br /> W.Cloyce Anders <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:American Alternative Ins.Co. 19720G <br /> INSURED Efland Vol.Fire Company,Inc. INSURER B: <br /> Kevin Brooks,Chief <br /> P.O.BOX 39 INSURER C <br /> Efland,NC 27243 INSURER D: <br /> 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 IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR L B POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MWDD/YYYY LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE $ 1,000,00 <br /> Ell <br /> A X COMMERCIAL GENERAL LIABILITY VFIS-TR-2057671 09/26/2012 0912612013 PREMISES Ea occurrence $ 1,000,00 <br /> CLAIMS-MADE 1K OCCUR MED EXP(Any one person) $ 10,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 3,000,00 <br /> GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 3,000,00 <br /> POLICY PRO- <br /> F—] X LOC $ <br /> AUTOMOBILE LIABILITY O aBINEDtSINGLE LIMIT $ 1,000,00 <br /> A X ANY AUTO VFIS-CM-1054758 09126/2012 09/2612013 BODILY INJURY(Per person) $ <br /> X ALL OWNED X SCHEDULED <br /> AUTOS AUTOS BODILY INJURY(Per accident) $ <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE <br /> AUTOS Per accident $ <br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 <br /> A X EXCESS LIAB CLAIMS-MADE VFIS-TR-2057671 09/26/2012 09/26/2013 AGGREGATE $ 4,000,00 <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN T Y LIMIT R <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? ❑ NIA E.L.EACH ACCIDENT $ <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> If es,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Orange County Emergency Services is included as Additonal Insured per <br /> contract. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Emergency Servic THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Jim Groves <br /> P.O.Box 8181 <br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE <br /> �V <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />