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CEDAR-1 OP ID:DP <br /> CERTIFICATE OF LIABILITY INSURANCE <br /> DATE 0111612014' <br /> 01/15/2014 <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 NAME,A T W.Cloyce Anders <br /> VFIS of North Carolina <br /> P.O.Box 12825 a"/coNN ,1:919-755-1401 FAX No,919-755-1125 <br /> Raleigh,NC 27605 E-MAIL <br /> W.Cloyce Anders ADDRESS: <br /> INSU S)AFFORDING COVERAGE NAIC# <br /> INSURED Cedar <br /> INSURER A:American Alternative Ins.Co. 19720G <br /> Grove Fire Dept.,Inc. <br /> Jeff Borland,Chief INSURER B <br /> 720 Hawkins Road INSURER C: <br /> Cedar Grove,NC 27231 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 <br /> LTR TYPE OF INSURANCE POLICY NUMBER MMILDD� MMIDDY EXP LIMITS <br /> WVD GENERAL LIABILITY <br /> EACH OCCURRENCE $ 1,000,0 <br /> A X COMMERCIAL GENERAL LIABILITY VFIS-TR-2059908 12/16/2013 12(1612014 DAMAGE $ 1,000,00 <br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,00 <br /> PERSONAL 6 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- X LOC $ <br /> AUTOMOBILE LIABILITY EeMBBIdINED INGLE LIMIT $ 1,000,0 <br /> A X ANY AUTO VFIS-CM-1056165 12116/2013 12/16/2014 BODILY INJURY(Per person) $ <br /> X ALL OWNED X SCHEDULED BODILY INJURY Per accident $ <br /> AUTOS AUTOS ( ) <br /> NON-OWNED PROPERTY DAMAGE <br /> HIREDAUTOS AUTOS PERACCIDEN $ <br /> X Com .$100 X Coll.$250 $ <br /> UMBRELLA LIAB HOCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED T RETENTION$ $ <br /> WORKERS COMPENSATION WC STATU- 9TH <br /> EMPLOYERS'LIABILITY YIN T RY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICEWMEMBER EXCLUDED? ❑ NIA <br /> E.L.EACH ACCIDENT $ <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> W yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L_DISEASE-POLICY LIMIT 1$ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Professional Healthcare is included in General Liability. <br /> Orange Co. is included as Additional Insured per VGLNCI "Who is an Insured" <br /> Blanket Additional Insureds. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County NC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 S.Cameron St. <br /> P.O.Box 8181 <br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE <br /> C 198�8-2010 ACORD CORPORATION. AN rights reserved. <br /> ACORD 25(2010/0.5) The ACORD name and logo are registered marks of ACORD <br />