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A ! T DATE(MMIDDIYYYY) <br /> t,``rr�/j � CERTIFICATE OF LIABILITY INSURANCE 06103/2014 <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 CONTACT NAME: <br /> Knight Insurance PHONE e:919-245.1020 c No):919-245-1010 <br /> 110 Boone Square Street,Suite 18 ADDRESS: kni htinsurance ralei h.twcbc.com <br /> Hillsborough,NC 27278 INSURERS AFFORDING COVERAGE NAIL If <br /> INSURER A: Hartford Underwriters Insurance Co <br /> INSURED INSURER B: <br /> Jeremy Michael Thompson INSURER G: <br /> 7917 Wolfe Ln,Lot i INSURER D! <br /> Snow Camp,NC 27349 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 R TYPE OF INSURANCE ADOL POLICY NUMBER Pmmyrn'FF MWDICY EXP <br /> LT LIMITS <br /> LTR <br /> GENERAL LIABILITY EACH OCCURRENCE $. <br /> .COMMERCIAL GENERAL LIABILITY DAMAGE T RENTE�Dn <br /> CLAIMS-MADE 1-7 OCCUR MED EXP(Any one pers ) $ <br /> ! PERVWAL B.ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $'.. <br /> POLICY 7 PRO- LOC <br /> AUTOMOBILE LIABILITY CdMBINED SINGLE LIMIT <br /> aced t <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident). .S. <br /> AUTOS NON-OWNED PROPERTY ade OEl DAMAGE S <br /> HIRED AUTOS AUTOS <br /> 5 <br /> UMBRELLA 4A$. OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION S $ <br /> WORKERS COMPENSATION WCSTATU- OTH- <br /> YIN T77 AND EMPLOYERS'LIABILITY RV LIMIT- <br /> A ANY PROPRIETORIPARTNER]EXECUTIVE. 6S60UB-8087707-A-13 12121113 12121114 E.L.EACH ACCIDENT $100,000 <br /> OFFICF EWMEMBER EXCLUDED? N i A <br /> (Mandatory in NH). E.L.DISEASE-EA EMPLOYEE $100,000 <br /> If yes describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE POLICY LIMIT $500,000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 961,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE' THEREOF, NOTICE WILL BE DELIVERED IN <br /> PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough,NC 27278 <br /> AUTHORIZED R RESF,fTATIVE <br /> C 1988-2010 -OR ORP TI . All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of OR <br />