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2014-181 Emergency Services for EMS Standby during Races $See Exhiibit C
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2014-181 Emergency Services for EMS Standby during Races $See Exhiibit C
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8/4/2014 8:51:19 AM
Creation date
8/4/2014 8:49:49 AM
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BOCC
Date
7/30/2014
Meeting Type
Work Session
Document Type
Contract
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Mgr Signed
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R 2014-181 ES - OC Speedway Management for EMS standby during races
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2014
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ACO CERTIFICATE OF LIABILITY INSURANCE M/DD/YYYY) <br /> 6/22/201/201 4 <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 INSL RER(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'NAIVED,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 /> i <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> Hyiant-Orlando PHONE FA' <br /> 250 International Pkwy, Ste 330 E-MAIL 14 -74 - A/I:,Ne):407-74 - <br /> Lake Mary FL 32746 ADDRESS: <br /> INSURERS AFFORDING COVERAGE NAIC X <br /> INSURER A:Greenwich Insurance Company 22392 <br /> INSURED ORANCOU-02 INSURER B: <br /> Orange County Speedway INSURERC: <br /> Management, LLC INSURERD: <br /> P.O. Box 107, 9740 NC Hwy 57 — <br /> Rougemont NC 27572 INSURERE: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:874468480 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FDR 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 SUBJE,-T TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADDL SUBR <br /> LTR TYPE OF INSURANCE <br /> IN SR WVD POLICY NUMBER MM DDY/YYYY MM DDS LIMITS <br /> A GENERAL LIABILITY AXGL0510046813 /1412014 /14/2015 EACH OCCURRENCE $1,000,000 <br /> DAMAGET RENTED <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $100,000 <br /> CLAIMS-MADE a OCCUR ME EXP(Any one persc n) $ <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> i <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 <br /> JECT <br /> POLICY PRO- LOC $ <br /> A AUTOMOBILE LIABILITY AXAL0510025013 /14/2014 114/2015 Ea acc dent $1,000,000 <br /> ANY AUTO BODILY INJURY(Per peison) $ <br /> ALL OWNED SCHEDULED id <br /> P <br /> BODILY INJURY(Per accent $ <br /> AUTOS AUTOS ( ) <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS Per accident <br /> A X UMBRELLA LIAB X OCCUR AXXSO410056113 /14/2014 /14/2015 EACH OCCURRENCE $1,000,000 <br /> X EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DED X I RETENTION$0 $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY <br /> Y I N TORY LIMITS FR <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? � N/A E.L.EACH ACCIDENT $ <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Certificate Holder Orange County Emergency Services is named as an Additional Insured with respect to General Liability, as required by <br /> written contract. <br /> �I <br /> I <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 /> Orange County Emergency Services ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 510 Meadowlands Drive <br /> Hillsborough NC 27278 AUTHORIZED REPRESENTATIVE <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br /> I <br />
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