Orange County NC Website
DocuSign Envelope ID: BBB12112-7901-46F7-A35E-DBFE81 FF4F12 <br /> C I DATE JMWDD YYY) <br /> iklv� CERTIFICATE OF LIABILITY INSURANCE <br /> 827204 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONL AND CONFERS D RIGHTS UPON THE CERTIFICATE HOLDER.. THIS <br /> CERTIFICATE ATE D ES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED DED 8 THE POLICIES <br /> BELOW. THIS CERTIFICATE ATE F INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> . <br /> IMPORTANT: If the certificate holder Is an ADDITI NAL INSURED, the p licy(les) 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 cartifleate does not confer rights to the <br /> certificate holder In Ilou of such endorsement(s). <br /> PRODUCER <br /> NA <br /> N CONTACT Lynn Linderman <br /> The Mechanic hank Group PHONE � � `735--070th �r No l. �845)735-8383 <br /> One Blue Hill, Plaza 'MAID .11ind.erman@me nicgro rn <br /> Suite 3 INSU E AFFORDING OVERAGE NAIG# <br /> Pearl River NY 10965 INSURER A-:Darr-l1 Select Insurance Company 43 .9 <br /> INSURED <br /> INSURER B 4 <br /> Southeastern Security Consultants Inc INSURER U <br /> 1853 Piedmont Road INSURER 0: <br /> Suite 10 INSURER E <br /> Marietta GA 30066 1 INSURER F A <br /> * ' AGE CERTIFICATE IFIL/ATE L/.RJBER:2 14-2015 REVISION MBER: <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 CONMTfON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE ANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AID CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN DEDUCED BY PAID CLAIMS. <br /> INSR ADDL SUBN wyD M �Y EF* �Y YYY QTR TYPE OF INSURANCE PS ICY#U�B�R � �D <br /> LIMIT <br /> GENERA.LIABILITY EACH OCCURRENCE 1,000,o <br /> X COMMERCIAL GENERAL LIABILITY DM WE TO RENTED <br /> PREMISES Ea occ Trance 100,000 <br /> X 'CLAIMS-MADE E OCCUR x 200--0189-01 /14/201 -.4/201.5 MED EXP(Any one person) 101000 <br /> Errors & omissions PERSONAL&AW INJURY it 000,000 <br /> GENERAL AGGREGATE 31000,000 <br /> EN'L AGGREGATE UMIT APPLIES PER: PRODUCTS-COM PIOP A , 00#000 <br /> X] POLICY F1 PRQ- <br /> JECT L0o <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> a aoddent <br /> ANY AUTO BODILY INJURY(Per person) <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS SDD€�� INJURY(Per accdert) <br /> NON-OWNED PROPERTY DAMAGE <br /> HIDED ALTOS AUTO Pera dent S <br /> UMBRELLA f.I F OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAWS-MADE AGGREGATE l ED RETENTION <br /> WORKERS COMPENSATION ill{ TATU- TH- <br /> AND EMPLOYER 'LIABILIT`f ER- <br /> YIN <br /> ANY PR PRIETOR1P RTNE RIEXECUTi E E.L.EACH A IDENT <br /> OFFICEPUMEMBE=R EXCLUDED? NIA <br /> (Mandatory In NH) <br /> .L DISEASE-EA EMPLOYE <br /> If es,dascritx�under <br /> D SCRIPTION O1=OPERATION below E-L.DISEASE-POLICY LIMIT <br /> OES RIPTION of OPERATIONS ILOCATIO /VEHICLE (Attach ACOI D iOl,Additional Remarks Schedule,it more space Is required) <br /> With respect to the Commercial Liability plan referenced, the below noted entities are included as <br /> Additional Insured per Endorsement #f CG 2010 (07/04) Additional Insured -- Owners, Lessors, or <br /> Contractors- Schedule Person or Organization. <br /> Orange County, its officers, official agents and employees <br /> CERTIFICATE MOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE E PIRATION D ATE THEREOF, NOTI E <br /> WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attn : Risk Management <br /> 2 � South Cameron Street AUTHORIZED REPRE REPRESENTATIVE <br /> PO Box 818 . <br /> Hillsborough, SIC 27278 <br /> Stage Mechanic/LYNN <br /> ACORD 25 (2010/06) 1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS0 oniflnsiAli Thin Arf)Pn names aril Inein nra raniQtpmri mn rkQ mf Af'npn <br />