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A Ro°0 CERTIFICATE OF LIABILITY INSURANCE 06/03/2014 <br /> THIS rzo�a m <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO LIGHTS 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 <br /> NAME: <br /> Knight Insurance PHONE xt:919-245-1020 FA^XrcN 919-245-1010 <br /> 110 Boone Square Street,Suite 18 ADDRESS:W. <br /> kni htinsurance ralei h.twcbc.cotn <br /> Hillsborough,NC 27278 INSURERS AFFORDING COVERAGE NAICS <br /> INSURERA: Hartford Underwriters Insurance Co <br /> INSURED INSURER 8: <br /> Felipe De Jesus Flores Gutierrez INSURER C: <br /> 5914 Christys Ln,Lot 6 INSURER O; <br /> Mebane,NC 27302 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 /> INSR TYPE OF INSURANCE INSR BR POLICY NUMBER MM/LDDY/YYYY1' POLICY LIMITS. <br /> LT. <br /> GENERALUABILITY EACH OCCURRENCE S <br /> COMMERCIAL.GENERAL LIABILITY- DA M PREMISES EaE wrrenee $. <br /> CLAIMS-MADE LI OCCUR MEO.EXP(Any one person).. S- <br /> PERSONAL&ADV INJURY. $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOP AGG 5 <br /> POLICY PRO- LOC S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> a accident) <br /> ANY AUTO BODILY INJURY(Per person) 5 <br /> ALL OWNED. SCHEOULED BODILY INJURY(Per accident) S <br /> AlfT05 NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS. -AUTOS iPer acciden <br /> S <br /> UMBRELLA:LIAS OCCUR EACH OCCURRENCE S <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED ..RETENTIONS S <br /> WORKERS COMPENSATION TWOCRY STATIT ER <br /> AND EMPLOYERS'LIABILITY O.N4 <br /> A ANY PROPRIETORIPARTNERIEXECUTIVE NIA BD877081 (12121/13 12121114 E.L.EACH ACCIDENT $100,000 <br /> OFFICERNEMBER EXCLUDED? El(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100,000 <br /> 11 yes.describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-M ICY I IMIT $500,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County Government <br /> PO BOX$1$1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Hillsborough,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZE RE"ESENTATNE <br /> C)1988- CORD C TION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks 01,,ACORD <br />