Orange County NC Website
��••� ® DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 04I2912014 <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(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 '4) <br /> AOn Risk Services Central, Inc. NAME: <br /> Philadelphia PA Office (A/C.No.Ext): (866) 283-7122 Fes,No.: (800) 363-0105 O <br /> One Liberty Place E-MAIL c <br /> 1650 Market Street ADDRESS: _ <br /> suite 1000 <br /> Philadelphia PA 19103 USA INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: Charter Oak Fire Ins Co 25615 <br /> SunGard Capital Corp. INSURER B: The Travelers Indemnity Co. 25658 <br /> its Companies & subsidiaries <br /> 680 East Swedesford Road INSURER C: The Phoenix Insurance Company 25623 <br /> Wayne PA 19087 USA INSURER D: Travelers Property Cas Co of America 25674 <br /> INSURER E: National union Fire Ins Co of Pittsburgh 19445 <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 570053604742 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. Limits shown are as requested <br /> LTR TYPE OF INSURANCE INSD WVD I POLICYNUMBER MMIDD MMIDD LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY D EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE ❑X OCCUR PREMISES Ea occurrence $1,000,000 <br /> X Contractual Liability MED EXP(Any one person) $101060 <br /> PERSONAL&ADV INJURY $1,000,000 v <br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,000 0 <br /> POLICY ❑JE T ❑X LOC PRODUCTS-COMP/OP AGG $:2,000,000 <br /> OTHER I Total Aggregate per policy $10,000,000 0 <br /> D T7-CAP-804SX05A-TIL-14 05/01/2014 05/01/2015 COMBINED SINGLE LIMIT <br /> AUTOMOBILE LIABILITY Ea ac dent $2,000,000 - <br /> Ix ANYAUTO BODILY INJURY(Per person) <br /> Z <br /> ALLOWNED SCHEDULED BODILY INJURY(Per accident) .d.. <br /> AUTOS NON-OWNED PROPERTY DAMAGE t@1 <br /> HIREDAUTOS X AUTOS Per accident) <br /> Comp/Coll Deductible $2,500 t: <br /> E X UMBREE LIAB X OCCUR 20562504 05/01/2014:05/01/2015 EACH OCCURRENCE $4,000,000 0 <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $4,000,000 <br /> DED X RETENTION$25,000 <br /> B WORKERS COMPENSATION AND TRJUB8045X04814 057017 2014 OS Ol 2015 X PER STATUTE ERH. <br /> EMPLOYERS'LIABILITY (AZ,MA,WI) <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $1,000,000 <br /> C OFFICER/MEMBEREXCLUDED4 IN TC2NUB8045X01214 05/01/2014 05/01/2015 <br /> (Mandatory in NH) (AOS) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,descnbe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000- <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br /> POLICY PROVISIONS. <br /> SunGard Capital Corp. AUTHORIZED REPRESENTATIVE <br /> Its Companies & Subsidiaries, <br /> 680 E. Road <br /> Wayne PA A 19087 19087 US USA I%rte// <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />