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DocuSign Envelope ID:6B8CE606-D5F5-4624-BCE9-FB4174BO97C3
<br /> NICEAND-01 JNE4VTON
<br /> ,�i e ra►. CERTIFICATE OF LIABILITY INSURANCE 712/22/2014 YJ
<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.: Jennifer S. Newton
<br /> WWlnfred C.Harper Agency PHONE 336 227-4271 zrx
<br /> PC7'Box 1857 dAPa I ..FKt),.(. .......... _� _ .. ... 4 C,No)_..
<br /> E-MAIL
<br /> 1037 S.Main Street ADDRESS Jennifer neVwton Q harperin$Urance com
<br /> Burlington,NC 27216-1867 .....,.. - .. ...........
<br /> INSURERS AFPORTNG COVERAGE NAIL d
<br /> ._.. ._....,.. _ 11111111111 .. ... ._.._ . ....
<br /> INSURER A;Erie Insurance Enchant a 126 71
<br /> INSURED INSURER B,
<br /> Nice&Green Flooring Solutions,LLC INS4 ER C:
<br /> 1183 University Drive#105.113 INSURER D
<br /> Burlington,NC 27215
<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 01 HER 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.LIMIT"S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> I� Ti/PIE OR INSURANCE _ .............a>LlttibL S11'Brz ... ............ .. ..... .......... ., POLICY tf .. POLICY EXP LIMITS
<br /> POUCY NUMBER MM1`DD/YYYY' MMiDD/YYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,00
<br /> DA ACE TORE
<br /> CLAIMS MADE /t
<br /> OCCUR )( Q34-0750764 g3dg7l2q14 g3Rg7P2q15 PREMISES.4 a.nrcanr cq _ 11600,00
<br /> MED EXIF(Avy ranee person)— s 5,00
<br /> . .. PFRSNAI w ADw xNTLIRY $ 1,000,00(
<br /> 1 POLICY RRNIERALA GRECATE s 2,gg0„q
<br /> GENL A(it"aREOAIE LIMIT"APPLIES PER I oaE
<br /> PRO- .......
<br /> LOC: � PIOP AGG�S 2,000,00(
<br /> OTHER: ..
<br /> AUTOMOBILE.LIABILITY I I COMBINED SGNCLE LIMIT $
<br /> ANY AUTO BODUY INJURY(Per person) S
<br /> .. .... ...... ... . ..
<br /> ALL OWNED �SCHEDULED 80rYLY INJURY(Per acadent) S
<br /> ALTCIS ALTOS
<br /> HIRED AUTC;N;� ....I AUUTOSWw'NECr I (P r accid nt)-----CE: S ..
<br /> �S
<br /> UMBRELLA UAB OCCUR � �EACH CCCUPRFNCI: ��
<br /> EXCESS LIAB I r:.LAlpwk"w MACE: AGGREGATE
<br /> ... . .. ..,_,.. ,,..,.._. ... ...... .... .. .......... _L_... ....., .... ..
<br /> ... r.
<br /> WORKER'S COMPENSATION RER CTH
<br /> AND EMPLOYERS'LIABILITY YIN .l sT,A.6 L1T1: -11 .... ..
<br /> ANY PRCPRIETOR�PARTNERIEX)ECUTIVE F.L.EAT H ALCIGENT $
<br /> IDFOFFICER,°h�1EMEIER EXCLUDE? NdA .._. .,..,,, .. .. _...,.
<br /> (es, in.NH) E L..DISEASE-EA EMPLOYEE S
<br /> If ra describe under ............ ... ---...
<br /> LY;i Cw1,RIP"TION OF OPERA-10NS kr0oww I E _DISEASE-POLlCY LIMIT {S
<br /> f
<br /> I I
<br /> � I
<br /> DESCRIPTION Or OPERATIONS/LOCATIONS P VEHICLES IACORD 101,Additional Remarks Schedule,may be attached it more space Is required)
<br /> The County of Orange,NO is an additional insured with regards to General Liability due to written contract
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> County of Orange THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> g ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> P.O.Box 8181
<br /> Hillsborough,NC 27278
<br /> Air THORIZED REPRESENTATIVE;
<br /> 1488-2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
<br />
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