Orange County NC Website
OP ID:SLS <br /> CERTIFICATE OF LIABILITY INSURANCE DAT 05/16D/YYYY) <br /> 05/16/14 <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 /> CONTACT <br /> PRODUCER Phone:919-286-7473 NAME: <br /> Dominick Huckabee Noblin Trent PHONE FAX <br /> Insurance Agency Fax:919-286-5170 A/C No Ext: <br /> A/C No): <br /> POBox 52239 E-MAIL <br /> Durham,NC 27717-2239 ADDRESS: <br /> PRODUCER KINGBRC <br /> J.G.Huckabee,III CUSTOMER ID K: <br /> _.______.__ _ INSURERS AFFORDING COVERAGE NAIC N <br /> INSURED King Brothers Electric Co,Inc INSURER A:State Auto Insurance 25135 <br /> Lee Anne King <br /> INSURER B <br /> 1701 Camden Ave. <br /> Durham,NC 27704 INSURER C: <br /> 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 /> I,TRR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MM DCD/YYYY) (MMIDDIYYYYI LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY SOC 2485972 04/01/14 04/01/15 AMP E RENTED <br /> PREMISES Ea occurrence) $ 100,00 <br /> CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ 5,00 <br /> PERSONAL 6 ADV INJURY $ _ 1,000,00 <br /> _ GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> POLICY X PRO- LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 <br /> A JX AN Y AUTO BAP2288261 04/01/14 04/01/15 (Eaaccident)BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Per accident) $ <br /> SCHEDULED AUTOS <br /> PROPERTY DAMAGE $ <br /> HIREDAUTOS (Per accident) <br /> rXI NON-OWNEDAUTOS $ <br /> UMBRELLA L.IAB X OCCUR EACH OCCURRENCE $ 5,000,00 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,00 <br /> A SOC 2485972 04101/14 04/01115 <br /> XdDEDUCTIBLE $ <br /> RETENTION $ 10,000 $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN <br /> ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? NIA <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 /> A Inland Marine SOC 2485972 00 04/01/14 04/01/15 R 55,00 <br /> InstFloat 504,00 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 9 ty ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD <br />