Orange County NC Website
'`�`_°.RO® CERTIFICATE OF LIABILITY INSURANCE DATE(M25/14YY1l) <br /> 07/25/14 <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 <br /> the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Aon Risk Services,Inc of Florida <br /> Aon Risk Services,Inc of Florida NAME: <br /> 1001 Bricke3 Bay Drive,Suite#1100 A/C NNo Ext:800-743-8130 aC No):800-522-7514 <br /> Miami,FL 33131937 <br /> EMAIL <br /> ADDRESS: ADP.COI.Center Aon.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A: New Hampshire Ins Cc 23841 <br /> INSURED INSURER B: <br /> ADP TotalSouroe FL XVI,Inc. <br /> 10200 Sunset Ddve INSURER C: <br /> Miami,FL 33173 <br /> L/C/F INSURER D: <br /> El Centro Hispano Inc. <br /> 600 East Main Street INSURER E <br /> Durham,NC 27701 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:878702 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. LIN41TS SHOWN ARE AS REQUESTED. <br /> INSR TYPE OF INSURANCE ADDL 3UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSR WVD MMIDD/YYYY MMIDD/YYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMAGES(RENTED <br /> PREMISES Ea occurrence) $ <br /> CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICYD PROJECT LOC $ <br /> COMBINED SING191TVIT-_ <br /> AUTOMOBILE LIABILITY Ea accident $ <br /> ANY AUTO BODILY INJURY Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY Per accident $ <br /> NON-OWNED UAMAUh <br /> HIRED AUTOS AUTOS Per accident $ <br /> UMBRELLA LAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEC I I RETENTION$ <br /> WORKERS COMPENSATION X WC STATU- OTH- <br /> A AND EMPLOYERS'LIABILITY YIN WC 094185644 NC 07/01/14 07/01/15 TORY LIMITS ER <br /> ANY PROPRIETORIPARTNERIEXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? NIA E.L.EACH ACCIDENT $ 2,000,000 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 2,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 2,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) <br /> All worksite employees working for the above named client company,paid under ADP TOTAL SOURCE,INC's payroll,are covered under the above stated policy. <br /> CERTIFICATE HOLDER CANCELLATION <br /> El Centro Hispano Inc. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 600 East Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Durham,NC 27701 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE �y <br /> V FOR(�L31�t�CtV[CGIJ, `LRC O (f&tW a <br /> ©1988-2010 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />