Orange County NC Website
Browse       Search
ACORQ. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 04/14/2014 <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(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 GUNTAGI <br /> NAME: <br /> Henry A Latimer & Son Inc PHONE <br /> o Eat: 301.229.1500 , No:301,320.2458 <br /> 4701 Sangamore Rd. Suite 5-250 ADDRESS: <br /> Bethesda, MD 20816 INSURER(S)AFFORDING COVERAGE NAICN <br /> INSURER A: Erie Insurance Company 26263 <br /> INSURED TischlerBise INSURERS: Erie Insurance Exchange 26271 <br /> 4701 Sangamore Rd INSURER C: Erie Insurance Property Casual <br /> Suite S240 INSURER 0: Travelers Indenmi ty Co <br /> Bethesda, MO 20816 INSURER E: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER:Orange County (NC) 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 LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MM/ MM/D UNITS <br /> GENERAL LIABILITY Q97014364 06/01/2013 06/01/2014 EACH OCCURRENCE $ 11000,0001 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 1,000,00 <br /> CLAIMS-MADE F—X]OCCUR MED EXP(Any one person) $ 5,00( <br /> A PERSONAL&ADV INJURY $ 2,000,00( <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00( <br /> POLICY PRO- <br /> JECT LOC $ <br /> AtlromoBlLE LIABILITY Q97014364 06/01/2013 06/01/2014 LIMIT <br /> (-Ea accident> $ 11000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> A ALL OWNED SCHEDULED BODILY INJURY(Per accident $ <br /> AUTOS AUTOS ) <br /> X HIRED AUTOS X NON-OWNED FKQFhRTY DAMAGE-- <br /> AUTOS (Per accident) $ <br /> $ <br /> UMBRELLA LIAS - X OCCUR Q30017154 06/01/2013 06/01/2014 EACH OCCURRENCE $ 1,000,00 A rX <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,00( <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION Q90510091 0610112013 06/01/2014 X uT <br /> AND EMPLOYERS'LIA91LI Y YIN <br /> TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTI E.L.EACH ACCIDENT $ ], <br /> 000,00 <br /> C (Mandatory In N ER EXCLUDED? N/A E.L.DISEASE-EA EMPLOYEE $ 11000,000 <br /> (Mandatory in NH) <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 190001000 <br /> Professional Liablity <br /> D �laims made 10578330 05/28/2013 05/282014 $1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,R more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County (NC) <br /> Planning Department AUTHORIZED REPRESENTATIVE <br /> P.O. Box 8181 <br /> Hillsborough, NC 27278 Richard Latimer, Sr. <br /> ®1988.2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />