Orange County NC Website
DATE(MMtDD/M i <br /> ASHIM). INSURANCE BINDER <br /> 3-6-99 <br /> THIS BINDER IS A TEMPORARY INSURANCE CONTRACT,SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE_OF_THIS FORM.s <br /> PRODUCER PHONE iOOMPANY BINDER# <br /> �wc,No,_ExtZ 919-489 1883 <br /> FIRST INSURANCE SERVICES, INC. PENN NATIONAL <br /> EFFECTIVE - --- --- .... -- EXPIRATION _ — <br /> DBA LES STOCKS & ASSOC. DATE TIME DATE TIME <br /> I PO BOX 52409 j X, AM X 12:01 AM <br /> DURHAM, NC 27707 1 2-27-95 12 :01 PM 12-31-95 -- NOON ; <br /> THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY <br /> CODE: SUB CODE: EXPIRING POLICY#: <br /> AGENCY - <br /> GENCYER ID: DESCRIPTION OF OPERATFONS/VEHICLEStPROPERTY(Including Location) <br /> LCUSTOM <br /> (INSURED <br /> COMFORT ENGINEERS, INC. & ORANGE ORANGE COUNTY VEHICLE <br /> ICOUNTY, SUB—CONTRACTORS, & SUB—SUB MAINTENCE FACILITY <br /> ( CONTRACTORS, ATIMA I <br /> lliFO BOX 2955, DURHAM. NC 27715 <br /> i <br /> !COVERAGES LIMITS <br /> TYPE OF INSURANCE COVERAGE/FORMS AMOUNT DEDUCTIBLE COINS% <br /> ;PROPERTY CAUSES OF LOSS <br /> BASIC BROAD SPEC "DIRECT PHYSICAL LOSS" SUBJECT TO I <br /> POLICY EXCLUSIONS AND CONDITIONS. $75,441 . $500. NA <br /> I <br /> __.X -RimmERs RISK <br /> GENERAL LIABILITY GENERAL AGGREGATE $ <br /> COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ <br /> CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ <br /> OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ <br /> FIRE DAMAGE(Any one fire) $ <br /> RETRO DATE FOR CLAIMS MADE: ! MED EXP(Any one person) $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> — B <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS BODILY INJURY(Per accident) `$ <br /> SCHEDULED AUTOS PROPERTY DAMAGE $ I <br /> HIRED AUTOS MEDICAL PAYMENTS $ <br /> NON-OWNED AUTOS PERSONAL INJURY PROT $ <br /> UNINSURED MOTORIST $ <br /> $ <br /> AUTO PHYSICAL DAMAGE DEDUCTIBLE ALL VEHICLES SCHEDULED VEHICLES ACTUAL CASH VALUE <br /> COLLISION: STATED AMOUNT $ t <br /> OTHER THAN COL - -- - - OTHER _ <br /> 1 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> i ANY AUTO OTHER THAN AUTO ONLY <br /> EACH ACCIDENT `$ <br /> AGGREGATE $ <br /> 1 EXCESS LIABILITY------- EACH OCCURRENCE -$ <br /> UMBRELLA FORM AGGREGATE $ <br /> OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: — SELF-INSURED RETENTION $ <br /> STATUTORY LIMITS <br /> WORKER'S COMPENSATION EACH ACCIDENT $ <br /> AND - -- - - - -- <br /> EMPLOYER'S LIABILITY DISEASE-_POLICY LIMIT $ <br /> I DISEASE-EACH EMPLOYEE $ <br /> I <br /> SPECIAL <br /> CONDITIONS/ <br /> OTHER SEE ATTACHED CANCELLATION CLAUSE <br /> COVERAGES <br /> NAME&ADDRESS _ <br /> { MORTGAGEE ADDITIONAL INSURED <br /> _LOSS PAYEE <br /> LOAN# <br /> AUTHORIZED REPRESENTATIVE <br /> . 4��l <br /> 'ACORD 75-5{3193] <u_ .= NOTE:IMPORTANT STATE INFORMATIO �REVERSE SIDE 0 ACORD CORPORATION:1993 <br />