Orange County NC Website
AC"R"°® CERTIFICATE OF LIABILITY INSURANCE DATE <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 CAME:ONTACT Lisa Crowe <br /> N <br /> Summit Insurance PHONE . (704)659-2141 1 FAX No,:(704)659-2148 <br /> 108 North Statesville Rd AMAIL :lcrowe @sumins.com <br /> PO Box 2485 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Huntersville NC 28078 INSURER A.Builders Mutual Insurance <br /> INSURED INSURER B: <br /> Habitat For Humanity Of Orange County, Nc, INSURERC: <br /> 88 Vilcom Center Dr. Ste L110 INSURER D: <br /> INSURER E: <br /> Chapel Hill NC 27514 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER;CL144901383 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 A DL UBR POLICY EFF POLICY EXP LIMITS <br /> LTR TYPE OF INSURANCE MYIL POLICY NUMBER MMIDDIYYYY MMIDDIYYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGT_TOR�N ED <br /> X I COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence, $ 1,000,000 <br /> A CLAIMS-MADE 7 OCCUR PP0058155 4/1/2014 /1/2015 MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> X POLICY PRO LOC $ <br /> AUTOMOBILE LIABILITY Ea accident)cde SINGLE LIMIT 1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> SCHEDULED CA0009233 4/1/2019 /1/2015 BODILY INJURY(Per accident) $ <br /> AUTOS NON--OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS (Per accident) <br /> I <br /> Medical Pavments $ 5.000 <br /> X UMBRELLA LAB OCCUR EACH OCCURRENCE - $ 2,000,000 <br /> A EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ 0025059 4/1/2019 /1/2015 $ <br /> A WORKERS COMPENSATION WC STIM T O R <br /> AND EMPLOYERS'LIABILITY YIN <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N I A E.L.EACH ACCIDENT $ 1 000 000 <br /> OFFICERIMEMBER EXCLUDED? CP1024619 4/1/2014 /1/2015 E.L.DISEASE-EA EMPLOYE $ 1 000 000 <br /> (Mandatory In NH) <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space Is required) <br /> Orange County is, listed as additional insured on general liability. <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 <br /> 200 S Cameron Street AUTHORIZED REPRESENTATIVE <br /> PO Box 8181 <br /> Hillsborough, NC 27278 <br /> Lisa Crowe/LCROWE :o - <br /> ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025 rnrinnrinl Tha a!_r1Rrl name and 11 nn are raniehararl marlrc of Or:f1Rn <br />