2013-518 EMS - New Hope Fire Department for Fire Protection Agreement

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i 'a1 NEWHO-1 OP ID:AJ A�RO� DATE Y)CERTIFICATE OF LIABILITY INSURANCE 1 01/07/201 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT W (.`IO ce Anders VFIS of North Carolina NAME: P.O.Box 12825 AHCNNo El::919-755-1401 A/c No):919-755-1125 Raleigh,NC 27605 E-MAIL W.Cloyce Anders ADDRESS: INSURERS)AFFORDING COVERAGE NAIC# INSURER A:American Alternative Ins.Co. 19720G INSURED New Hope VFD of Orange Co,Inc INSURER B: Mike Tapp,Chief PO Box 16484 INSURER C: Chapel Hill,NC 27516 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE RUUL U POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DDIWW GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 • X COMMERCIAL GENERAL LIABILITY VFIS-TR-2053688 06/11/2013 06/11/2014 PREMISES(Ea Ea occurrence) $_ 1+000+00 CLAIMS-MADE 1 OCCUR MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 3,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,00 POLICY PRO- X LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1000,000 Ea accident $ _+ • JX ANY AU TO VFIS-CM-1052253 06/11/2013 0611112014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS 1XCOII:AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS PER ACCIDENT OTC: $250 $50 $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ 2,000,00 • X EXCESS LIAB HCLAIMS-MADE VFIS-TR-2053688 06/11/2013 06111/2014 AGGREGATE $ 4,000,00 DIED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN T R ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Management VFIS-TR-2053688 0611112013 0611112014 Aggregate 3,000,00 Wrongful 1,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Commercial Blanket Bond, $100,000 limit; Blanket Portable Equipment is on Guaranteed Replacement Cost with $100 Deductible; Orange County is included as an Additional Insured per Form VGLNCI, "Who is An Insured, Blanket Additional Insureds". See NotePad for Property Coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ty ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough,NC AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD