Orange County NC Website
CERTIFICATE OF LIABILITY INSURANCE 053 4/2/2/014 Y) <br /> THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED,subject to the <br /> 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 CONTACT <br /> NAME: <br /> COMMERCIAL INSURANCE.NET LLC/PHS PHONE <br /> /C <br /> (A .NO,Ert): (866) 467-8730 ( .NO): (888) 443-6112 <br /> 383397 P: (866) 467-8730 F: (888) 443-6112 ADDRESS: <br /> PO BOX 33015 INSURER(S)AFFORDING COVERAGE NAIC# <br /> SAN ANTONIO TX 78265 INSURER A: Sentinel IRS Co LTD <br /> INSURED <br /> INSURER B: <br /> INSURER 0: <br /> CALEB CHILDERS DBA MALACHI FILMS INSURER D: <br /> 1323 DAVIS RD INSURER E: <br /> HILLSBOROUGH NC 27278 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 <br /> TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUER POLICYNUMBER POLiCYEFF POLICYEXP <br /> MMIDD LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s2, 000, 000 <br /> CLAIMS-MADE F--7 OCCUR DAMAGE T rrO RENTED S 1 I O O 0 O O O <br /> PREMISES(Ea occuence) i <br /> A X General Liab 38 SBM BW2261 04/01/2014 04/01/2015 MEDEXP(Anyoreperson) $10, 000 <br /> PERSONAL&A.DV INJURY s2, 000, 006—0 0 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s4, 000, 000 <br /> PRO 54, 000,000 <br /> POLICY JECT Y' LOC PRODUCTS-COMP/OP AGG <br /> OTHER: <br /> S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) s2, 000, 000 <br /> ANY AUTO BODILY INJURY(Per person) S <br /> A ALL OWNED SCHEDULED 38 SBM BW2261 04/01/2014 04/01/2015 BODILY INJURY Per accident <br /> AUTOS AUTOS ( ) S <br /> X HIREDAUTOS X NON-OWNED PROPERTY DAMAGE <br /> AUTOS <br /> (Per accident) $ <br /> S <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION E $ <br /> WORKERS OOMPENSATI ON PER <br /> AND EMPLOYERS LIABILITY STATUTE OT H- <br /> ANY PROPRIETOR/PARTNERIEXECUTIVE YM E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? El NI A <br /> Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under $ <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> Those usual to the Insured's Operations. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ORANGE COUNTY GOVERNMENT AUTHORIZED REPRESENTATIVE <br /> 200 S CAMERON ST <br /> HILLSBOROUGH, NC 27278 / <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />