Orange County NC Website
Browse       Search
DocuSign Envelope ID:28C70191-ACED-41 1A-B232-07CC312698DA <br /> ,a►co CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 12/11/2014 <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 Charline Gr der <br /> NAME: y <br /> Bagwell & Bagwell Insurance LLC PHONE (g19)832-6667 NC No;(919)856-0769 <br /> 2626 Glenwood Ave. E-MAIL <br /> ADDRESS:Charline @1919bb.com <br /> Suite 300 INSURERS AFFORDING COVERAGE NAIC# <br /> Raleigh NC 27608 INSURER A:Standard Fire Ins Co. 19070 <br /> INSURED INSURER B: <br /> RIVERS AGENCY, LLC INSURERC: <br /> 601 W. ROSEMARY ST. INSURERD: <br /> UNIT #108 INSURER E: <br /> CHAPEL HILL NC 27516 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER CL14113002291 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MMIDDIYYYY MMIDDIYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> PREMISES Ea occurrence $ <br /> CLAIMS-MADE 7 OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ <br /> POLICY PRO- <br /> ] LOC $ <br /> AUTOMOBILE LIABILITY COEa accident MBINED SINGLE LIMIT <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIREDAUTOS AUTOS Peraccident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> A WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE❑ N/A E.L.EACH ACCIDENT $ 500,000 <br /> OFFICER/MEMBER EXCLUDED? ICUB8D18230214 11/5/2014 11/5/2015 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE' $ 500,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT $ 500,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Chapel Hill/Orange County Visitors Bureau ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 501 W. Franklin Street <br /> Chapel Hill 27516 AUTHORIZED REPRESENTATIVE <br /> Charline Gryder/CG <br /> ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025 oninn.m m The Arnpin name and Innn arc reniefererl mnrlcc of Arnpin <br />