|
07/08/2014 19:54 9197329636
<br /> PAGE 01
<br /> ORANG-3 OP IU_:WS
<br /> ���-•�I_0� DATC IMMIDO; .ti"I-F CERTIFICATE OF LIABILITY INSURANCE 0410912014
<br /> THIS CERTIFICATE 10 I ourD AG A MATTMR OF INFORMATIAN nNLY AND CONFERS NO RIGHTS UPON THE CERTIFICATIF HOLDER THIS
<br /> CERTIFICATE DOE5 NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PC!Iclts
<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 pollcy(Jes)must be endorsed. If SUBROUA I PON IS WAIVED,sub;7__(v
<br /> the terms and conditions of tho policy,certain pollclas may require an endorsemont• A statement on this CGrUfloate does not confer rlghb3 to t1v)
<br /> Certificate holder In Ileu of such endorsoment(s).
<br /> PRODUCER goNenc7 W. -----_____
<br /> VFIS of North Carolina NN CloycA Anders -. -
<br /> P.O.Box 12826 PKONE 919-756.1401 ,q7(
<br /> arc No Ex11; A/G rya):919-755.19 26
<br /> Raleigh,NC 27805 E.MkIC'. •' •• ------
<br /> W,CloyCa Anders ADDRESS:�
<br /> _ IN9UkERIS)APFOROINO COVERAGE nFI( n
<br /> INSURERA:Amerfcan Alternative Ins.CO, _19720G
<br /> INSURED Orange Rural Fire Dept'1401 Inc INSURSR0;
<br /> Jeff Cabe,,Chief -----
<br /> P.O.Box 1511 INSURER C
<br /> Hillsborough,NC 27278 INSLIFMA0
<br /> INSUR @R E I
<br /> INSURER F I .- •.. '-".-- -'-—.__._._ --
<br /> COVERI\G65 CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVU FUN IMF POLIGY f'eR cD
<br /> INDICATFO, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICr 'HIS
<br /> CERTIPICATE MAY 13E ISSUED OR MAY PERTAIN, THE INSURANCE APFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE--EFNS,
<br /> "ULUSIONS AND CONDITIONS OF 3UCI I POLIOIGE,LIMITS SHOWN MAY HAVE RFFN RFOUCED BY PAID CLAIMS.
<br /> fLTR? TYPOOFINSVRA14CIS POLICY NUMBS V MMIDDYEFF MIDD EXP V LIMITS
<br /> A X COMMERCIAL6ENERALUA9ILITY EACH OCCURRENCE is !000,00
<br /> _ CLAIMS-MADE u OCCUR VFI5-TR-205257t1-U1 04/14/2014 04114/2018 _ R AIS s LA OCeurrencal y s r o lei nnn
<br /> ,,,_ „ MEbfiXPAnyon9Pnrson�� —_ --5,000
<br /> _ PERSONAL BADV INJURY S 1. 90,00
<br /> GEN'LAGOREOATE LIMIT APPLIE8PER: - OENFRALAG_OREWE _ b 0,000
<br /> POLICY L.,-I J8PT X LOO PRODUCTS-CONPIOP_AGO S _.. .-_..3-.000,00
<br /> CTHFR: S
<br /> AUTOMOBILBLIABILITY bINED•Sf UI. L y -1.,000,00o
<br /> A X -e gcgidonlJ ,-• -••------- --
<br /> ANY AUTO VFIS•CM•1051614.07 04/14/2014 04/14/2015 BODILY INJURY(For pnrron) 5
<br /> X AUTOS LU X AUTOSULCD 9MILV IN II11tV(Par,ceklenll S
<br /> X HIRED AUTOS X
<br /> NON Por PERT—TnidXGE S
<br /> UMBRELLA X OCCUR EACH OCCURRENCE S 5,000,00
<br /> A X EXCE95 LIN CLAIMS-MADE FIS-TR.2062575-07 04/14/2014 04/14/2015 FAGG & g 10.000,000
<br /> _ _-
<br /> D[D RETGt 16Jp S
<br /> WORKERS COMPENSATION K V
<br /> AND EMPLOYERS'LIABILITY TATUTE E
<br /> ANY PROPRIETOR1PAR7NER/EXECVTIVE Y/N E,L EACH ACCID 5
<br /> ENT
<br /> r1CGIr:FRnlFMRFR RXCLUDED9 ONIA
<br /> -.
<br /> (Mandatory In NH) E,I_.DISEASE-E4 RMPI nYFF S
<br /> If a s,dadadbeunder -' -••• ----
<br /> D v RIPTION OF OPERATIONS below RL.DISEASE-POLICY LIMIT •f _
<br /> A Real Property VFl9-TR-2052575-07 04114/2014 04/14/2015 Building GRC
<br /> Personal Proporty FIS-TR-2052575-07 04114/x014 04114/2015 Contents k31kt RC
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACOKO 101,AddlOoRal Rumarka 8040%ila,may be attaspad It moM 80moo Ia mqulrad)
<br /> Commercial Blanket: Bond with a $900 000 limit. Portable EgWpment On
<br /> Guaranteed ReplAawment Cost with a 4500 Deductible. Management Liability
<br /> $1,000,000 Each Wtbngful Act, $3,000,000 Aggregate. Orange County is
<br /> included ae an JLddi.tienaJ. Tnallrnd per form VGLNCI "Oho Is An XnSured Blanket
<br /> Additional Insureds",
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHUVLL)ANY OF THE ABOVE DESCRIBED POLIGIW RC CANCELLSO c c FO RE
<br /> Orange County THE EXPIRATION DATE THUREOF, NOTICE WILL BE DEUVERED IN
<br /> P.O.Box 8181 AOOOROANCE WITH 111E POLICY PROVI810NS.
<br /> Hillsborough,NO 27278 AUTHORIiEOREPRESENTATNE
<br /> C 1988-2014 ACORD CORPORATION- All rights reservod,
<br /> ACORD 26(2014101) The ACORD name and logo are registered marks of ACORO
<br />
|