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DocuSign Envelope ID:68F4D2C0-E330-423E-BCO2-F830CC1A8435 <br /> 2, DATE Y)AC® <br /> � / CERTIFICATE OF LIABILITY INSURANCE 02/02!2015 <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 /> NAME: <br /> Gladwell Insurance Agency Inc PHONE <br /> A No,Ext: 336 299-5185 FaAic No):(336)852-3676 <br /> 5709 W.Friendly Ave.,27410 E-MAIL <br /> PO Box 8070 ADDRESS:staffing ladwell insurance.com <br /> Greensboro,NC 27419 PRODUCER <br /> CUSTOMER ID#: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURERA: Erie Exchange <br /> Law Enforcement Services Inc <br /> 3409-A West Wendover Ave INSURER B: <br /> Greensboro,NC 27407 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 /> ILTR TYPE OF INSURANCE INSR WVDR POLICY NUMBER MM/DID�Y MM DDIYYYY LIMITS <br /> A GENERAL LIABILITY Q421690087 6/16/2014 6/16/2015 EACH OCCURRENCE $ 2000000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGERENTED <br /> PREMISES S(Ea occurrence) $ _ 2000000 <br /> CLAIMS-MADE X❑OCCUR MED EXP(Any one person) $ 5000 <br /> PERSONAL&ADV INJURY $ 2000000 <br /> GENERAL AGGREGATE $ 4000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4000000 <br /> X POLICY PE� LOC $ <br /> A AUTOMOBILE LIABILITY Q061630192 6/16/2014 6/16/2015 COMBINED SINGLE LIMIT <br /> (Ea accident) $ <br /> X ANY AUTO BODILY INJURY(Per person) $ 250000 <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Per accident) $ 500000 <br /> SCHEDULEDAUTOS <br /> PROPERTY DAMAGE $ 100000 <br /> HIRED AUTOS (Per accident) <br /> NON-OWNED AUTOS $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> A AND EMPLOYERS'COMPEN A TIOI N YIN Q922400462 8/24/2014 8/24/2015 X WC S LAMTIUS of H- <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 100000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 100000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY EMERGENCY SERVICES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 510 MEADOWLANDS DR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> HILLSBOROUGH NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ATTN DINAH JEFFRIES djeffries @orangecountync.gov AUTHORIZED REPRESENTATIVE <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD <br />