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OP ID: DJ <br /> A�co�R° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDfYYYY)F 08/15/14 <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 the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER 919-913-1144 CONTACT <br /> High&Rubish Insurance Agency PHONE FAX <br /> P.O.Box 3040 919-913-1155 A/C NE E,d: A/C No): <br /> 6015 Farrington Rd.Ste 101 ADDRESS: <br /> Chapel Hill,NC 27517 PRODUCER <br /> Jeffrey A.Rubish CUSTOMER ID#:OCIM--1 <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED Orange Congregations In INSURER A:Hartford Insurance Company 10677 <br /> Missions, Inc. -INSURER B: <br /> 300 Millstone Drive <br /> Hillsborough, NC 27278 INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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. <br /> INSR TYpE OF INSURANCE DDL POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DDIYYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY EBP0069499 10115/13 10/15/14 PREMISES Ea occurrence $ 300,00 <br /> CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> POLICY 7 PRO LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS BODILY INJURY(Per accident) $ <br /> SCHEDULED AUTOS <br /> PROPERTY DAMAGE $ <br /> HIRED AUTOS (Per accident) <br /> NON-OWNED AUTOS $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE❑ E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED N/A <br /> (Mandatory in NH) E L DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Grant <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANG-1 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> ORANGE COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> OR <br /> OR Millstone Dr ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 300 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE <br /> 0- <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD <br />