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DATE (MMIDD/YYYY)
<br /> ACOROe CERTIFICATE OF LIABILITY INSURANCE
<br /> 06/10/2014
<br /> THIS CERTI"ICATE 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 Phone: (336)475-9762 Fax: (336)472-9160 CONTACT_ Insurance Service Corp.of America
<br /> NAME:INSURANCE SERVICE CORP.OF AMERICA PHONE -- — - FAx -- --
<br /> P.O.BOX 2399 Lc No Exth (336)475 9762 _ IL,vc No): (336)472-9160
<br /> -- - - —
<br /> E-MAIL
<br /> THOMASVILLE NC 27361 'ADDRESS Nanc: Y@ ISCofA.com
<br /> INSURERS)AFFORDING COVERAGE NAIC#
<br /> INSURED. -_ _ - --.--.__ --__..
<br /> wsURERA :CNA-PL 31127
<br /> ENT LAND SURVEYS,INC INSURER :Travelers Property Casualty Co of America 25674
<br /> 226 SOUTH CHURTON ST INSURER :Travelers Indemnity Co 25658
<br /> HILLSBOROUGH NC 27278 INSURER D: Travelers Indemnity Co 25658
<br /> INSURER :Phoenix Insurance Co TRAVELERS 25623
<br /> INSURER F
<br /> COVERAGES CERTIFICATE NUMBER: 11114 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 ADDL SUER POLICY EFf POLICY EXP
<br /> _ TYPE OF INSURANCE _ _@1MIDDIYYYY (WWDD/YYYY _ _
<br /> LTR --___-� -_.. _-_.- INSD WVD POLICY NUMBER LIMITS
<br /> B X !,COMMERCIAL GENERAL LIABILITY X X 6801623N240 02/01/14 02/01/15 EACH OCCURRENCE $ 1,000,000
<br /> J CLAIMS-MADE I X OCCUR -DAMAGE TO RENTED 300,000
<br /> jPREMISES(Ea occurence) $
<br /> GEN MED.EXP(Any one person) $ 5,000
<br /> PERSONAL 8 ADV INJURY $ 1,000 000
<br /> �GENERAL AGGREGATE $ 2,000,000
<br /> L AGGREGATE_ S PER: --- - , --- --- -
<br /> JECT
<br /> POLICY L.�JECT f LOC ! ! RODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: _ $
<br /> `. AUTOMOBILE LIABILITY li ,, BA16,.35N460 02/01/14 02/01/15 (Ea EDSINGLE LIMIT
<br /> Eadent) 1 $ 1,000,000
<br /> X ,ANY AUTO -,. SCHEDULED 'I BODILY INJURY(Per person) $
<br /> ALL OWNED
<br /> AUTOS --
<br /> AUTOS BODILY INJURY(Per accident) $
<br /> NON-OWNED ---- ----- - -
<br /> HIRED AUTOS PROPERTY DAMAGE $ --
<br /> ---i AUTOS (peraccidenl)
<br /> -
<br /> _-.-___ $
<br /> D X 1E EXCESS X occuR CUP2345T127 02/01/14 02/01/15 EACH OCCURRENCE $
<br /> X X --- 1,000,000
<br /> _-_DED AGGREGATE $ 1,000,000
<br /> WORKERS COMPENSATION $ ,
<br /> CLAIMS-MADE
<br /> E T 10 000 + UB3663T324 02/01/14 02/01/15 X sinTUrE T ER
<br /> AND EMPLOYERS LIABILITY _�J _- 4-
<br /> ANY PROPRIETORIPARTNER/EXECUTIVE YIN
<br /> OFFICER/MEMBER EXCLUDED? �— �E ..EACH ACCIDENT $ 500,000
<br /> (Mandatory In NH) I� DISEASE-EA EMPLOYEE $ 500,000
<br /> If yes,describe under -- --- , --tDESCRIPTION OF OPERATIONS below .DISEASE POLICY LIMIT $ 500,000
<br /> A IProfessioanl Liability LSH288321942 02/08/14 02/08/15 $1,000,000 Per Claim$2,000,000 Annual Ag
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD
<br /> D 101,Additional Remarks Schedule,may be attached it more space is required)
<br /> Orange County,its officers,official agents and employees are listed as additional insured on the General Liability Policy where required
<br /> by written agreement ATIMA,and Wavier of Subrogation is in favor of certificate holder(See attached CG D3 81 09 07)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> I
<br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 200 South Cameron Street, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Hillsborough,NC 27278 - —— ---- -
<br /> AUTHORIZED REPRESENTATIVE
<br /> Attention: Risk Management
<br /> ACORD 25(2014/01) ©1988-2014 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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