Orange County NC Website
�•��� ORANG-7 OP ID:BW <br /> ,4�co�zr�►• CERTIFICATE OF LIABILITY INSURANCE <br /> DATE <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 <br /> Summers Thompson Lowry,Inc. NNAMMrE: Beth Wilkerson FAX <br /> PHO <br /> 100 Europa Drive,Suite STf Arc No Ell_919-969-5322 , -919-942-4221 <br /> Chapel Hill,NC 27517 E-MAIL bath @stlinsure.com <br /> Larry A.Summers ADDRESS: <br /> INSURERS)AFFORDING COVERAGE NAIC t <br /> INSURER A;*Alliance for Non-Profits for <br /> INSURED Orange County Partnership for INSURER B:Hartford Casualty Ins.Co. 29424 <br /> Young Children INSURER C: <br /> 120 Providence Rd Ste 101 <br /> Chapel Hill,NC 27514 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 /> ILTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YFYtt MNW�YY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY 201336915 08110/2013 08/10/2014 ERE AGE T RENTED occurrence $ 500+00 <br /> CLAIMS-MADE OCCUR MED EXP(Any one person) $ 20,00 <br /> PERSONAL&ADV INJURY $ 1:000, <br /> GENERAL AGGREGATE $ 3,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,00 <br /> POLICY PRO- <br /> iECT LOC $ <br /> AUTOMOBILE LIABILITY COMBINED INGLE L IT 1 ,000 <br /> 00 <br /> Ea accident � <br /> A ANY AUTO 201336915 08/1012013 0$11012014 BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS PER ACCIDENT <br /> $ <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 <br /> A EXCESS LIAR CLAIMS-MADE 201336915UMS 08/1012013 08/10/2014 AGGREGATE $ 1,000, <br /> DEC) X RETENTION$ 10000 $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY X Y TORY IMITS ER <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 22WECIT8297 10/01/2013 10/01/2014 E.L.EACH ACCIDENT $ 500,00 <br /> OFFICERIMEMBEREXCLUDED' N/A <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,00 <br /> If yes,describe ender --- ......... <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,00 <br /> A Liquor Liability 201336915 08/10/2013 08/10/2014 Ea Occ 1,000,00 <br /> Aggregate 1,000,00 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,AddRional Remarks Schedule,R more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGEI <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 S.Cameron St <br /> Hillsborough,NC 27276 AUTHORIZED REPRESENTATIVE <br /> O 1986-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />