Orange County NC Website
l ffi DATE(MWDD/YYYY) ' <br /> AaRL' CERTIFICATE OF LIABILITY INSURANCE <br /> 1/8/2014 <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(les)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 <br /> CONTACT <br /> NAME: Chrms F_ Brantley <br /> Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX Ne: - - <br /> P.O. Drawer 16447 E-MAIL <br /> Jackson MS 39236-6447 ADDRESS. <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A <br /> INSURED INSURER B: <br /> Neel-Schaffer Inc., Maptech, Inc; SoilTech INSURERC: <br /> Consultants,Inc;Premier Emergency Management,LLC; INSURERD: <br /> True North Emergency,LLC <br /> P. O. Box 22625 INSURER E <br /> Jackson MS 39225-2625 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:461126528 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 I TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS <br /> LTR INSR WVD POLICY NUMBER MM/DDMlYY MM/DD/YYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMA REN D <br /> COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ <br /> CLAIMS-MADE D OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERALAGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICY PRO LOC $COMBINED 5ING" <br /> AUTOMOBILE LIABILITY Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> Par.ccident <br /> HIRED AUTOS ON $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> A <br /> WORKERS COMPENSATION 6291454190013 /1/2013 /1/2014 X WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $1,000,000 <br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> The Producer will endeavor to mail 30 days written notice/10 days for non-payment to the Certificate Holder named on the certificate if any <br /> policy listed on the certificate is cancelled prior to the expiration date. Failure to do so shall impose no obligation or liability of any kind upon <br /> the Producer or otherwise alter the policy terms. <br /> CERTIFICATE HOLDER CANCELLATION 10 Day Notice for Non-Payment Premiu <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P.O.Box 8181 <br /> Hilsboro NC 27278 AUTHORIZED REPRESENTATIVE <br /> ©1988-2010 ACORD CORPORATION, All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />