Orange County NC Website
' C> °� CERTIFICATE OF LIABILITY INSURANCE 1//21/DATE <br /> 217,/DD/YYYY) <br /> � 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(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 Clint Chappell <br /> Jennings Bryan-Chappell Insurance Services PHONE (335)227-7458 AX ,(3%)343-1000 <br /> PO Box 1118 .elint@jbcins.com <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> Burlington NC 27216 INSURER A;Philadel hia Insurance Cc 18058 <br /> INSURED tNsuRERs,United Heartland <br /> OE Enterprises, Inc. INSURERC: <br /> 348 ELIZABETH BRADY ROAD INSURER D: <br /> INSURER E: <br /> HILLSBOROUGH NC 27278 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:CL1412100512 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 /> MSS TYPE OF INSURANCE ICY E>•. P U Y EXP <br /> POLICY NUMBER MID LIMITS <br /> GENERAL LIABILITY 1,000,000 <br /> EACH OCCURRENCE $ <br /> X COMMERCIAL GENERAL LIABILITY PR I - )- $ 100,000 <br /> A CLAIMS-MACE t X l OCCUR P HPK1039785 /30/2013 /30/2014 MED EXP(Any one person) $ 5,000 <br /> X Prof E60 PERSONAL&ADV INJURY $ 1,000,000 <br /> A X Employee Benefits HSD841592 6/30/2013 /30/2014 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 COM aacol I 1,000,000 <br /> 000 <br /> A Ix ANY AUTO BODILY INJURY(Per person)ALLOWNED SCHEDULED HPK1039785 6/30/2013 /30/2014 BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS NON-OWNED PROPERTY.... DAMAGE $ <br /> HIRED AUTOS AUTOS i <br /> Motkoai eats $ 5,000 <br /> X UMBRELLA LIAO X OCCUR EACH OCCURRENCE $ 4.,000,000 <br /> A EXCESS UAB CLAIMS-MADE AGGREGATE $ 4,000,000 <br /> DEC) X RETENTI N 10,00 HUB425686 /30/2013 /30/2014 $ <br /> $ WORKERS COMPENSATION I AYSTATU - <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L EACH ACCIDENT $ 500- 000 <br /> OFFICERIMEMBER EXCLUDED? N I A <br /> (Mandatory in NH) 400120327 /1/2013 /1/2014 E_L DISEASE-EA EMPLOYEE S 500,000 <br /> If yye�s,describe under <br /> O.ESCRIPTIONOFOPERATIONSbelow E.LDISEASE-POLICY LIMIT, $ 500,000 <br /> A Directors/Officers HSD941592 /30/2013 /30/2014 D&O 3,000,000 <br /> A EPLI HSD841592 /30/2013- /30/2014 EPLI 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,H 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 /> Town of Carrboro ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 301 W. Main Street <br /> Carrboro, NC 27510 AUTHORIZED REPRESENTATIVE <br /> Clint Chappell/CC <br /> ACORD 25(2010/05) 01988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025 nnlnnsl m Tha arnprl name anti Inn^nra ranieta►atl mark¢of er[nRrt <br />