Orange County NC Website
DocuSign Envelope ID: C5AE60ED-3944-4BD4-888D-03C35A9C4941 <br />PolicyNumberFILENUMBER4119520DateEntered:3/17/2015 <br />MIDD1YYYY} <br />3/17/2015 <br />THISCERTIFICATEISISSUEDASAMAnEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTIRCATEHOLDER.THIS <br />CERTIFICATEODESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIES <br />BELOW.THISCERTIRCATEOFINSURANCEODESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZED <br />REPRESENTATIVEORPRODUCER,ANDTHECERTIFICATEHOLDER. <br />IMPORTANT: <br />IfSUBROGATIONISWAIVED,subjectto <br />IfthecertificateholderisanAOOITIONAlINSURED,thepolicy(ies)mustbeendorsed. <br />thetermsandconditionsofthepolicy,certainpoliciesmayrequireanendorsement.Astatementonthiscertificatedoesnotconferrightstothe <br />certificateholderinlieuofsuchendorsement(~). <br />CONTACT <br />PRODUCER <br />NAME: <br />HarrisonInsuranceInc. <br />Agency, <br />.(512)367-5722 <br />r~2N9oFdl,(512)377-6869 <br />No <br />5806WoodrowAve. <br />Austin,TX78756 <br />INSURER/51AFFORDINGCOVERAGE <br />NAIC" <br />COMPANY <br />INSURERA:MARRELEVANSTONINSURANCE <br />LLC. <br />STEALTHPOWER, <br />INSURED <br />INSURER <br />3300 <br />BEECAVESRD. <br />INSURER0: <br />TX78746 <br />AUSTIN, <br />INSURERE: <br />INSURERF: <br />COVERAGESCERTIFICATENUMBER:REVISIONNUMBER: <br />THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIOD <br />INDICATED,NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS <br />CERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS. <br />EXCLUSIONSANDCONDITIONSOFSUCHPOLICIES.LIMITSSHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS. <br />POLICYEFFPOLICYEXP <br />INSR <br />TYPEOFINSURANCELIMITS <br />POLICYNUMBER <br />MMIOOIVVYVMM/DOIVVYY <br />A <br />COMMERCIALGENERALLIABILITY <br />sl,OOO,OOO <br />EACHOCCURRENCE <br />s75,OOO <br />SP869601 <br />CLAIMS-MADEOCCUR <br />~~~~~~J~F~~~r~Bnce\ <br />SN/A <br />MEDEXP(Anyoneperson) <br />Sl,OOO,OOO <br />PERSONALADVINJURV <br />& <br />$2,000,000 <br />GENERALAGGREGATE <br />Sl,OOO,OOO <br />PRODUCTS-COMP/OPAGG <br />POLICVJEeTLOC <br />eductible <br />000 <br />s5, <br />OTHER' <br />COMBINEDSINGLELIMIT <br />AUTOMOBILEL1ABIlITV <br />Eaaccident <br />BODILVINJURV(Perperson) <br />ANVAUTO <br />SCHEDULED <br />ALLOWNED <br />BODILVINJURV(Peraccident) <br />AUTOSAUTOS <br />NON-OWNED <br />PP~~~;c~~gAMAGE <br />HIREDAUTOS <br />AUTOS <br />s <br />UMBRELLAL1AB <br />EACHOCCURRENCE <br />HOCCUR <br />EXCESSLIAS <br />CLAIMS-MADEAGGREGATE <br />OEDRETENTIONS <br />WORKERSCOMPENSATION <br />~~fTlJTE~~H- <br />ANDEMPLOVERS'LIABILITY <br />ANYPROPRIETOR/PARTNER/EXECUTIVEE.l.EACHACCIDENT <br />OFFICERIMEMBEREXCLUDED? <br />(MlndltoryInNH)E,L.DISEASE-EAEMPLOVE <br />IIyes.descnbeunder <br />EL.OISEASE-POllCVLIMIT <br />DESCRIPTIONOFOPERATIONSbelow <br />DESCRIPTIONOFOPERATIONSILOCATIONS1VEHICLES(ACORD101.AdditionalRema•.••s$ehedule,maybeattaehedmorespaceIsrequired) <br />INSURED <br />POWERSYSTEMS,ALLRELATEDPREMISESANDOPERATIONSOFTHE <br />ELECTRICAL <br />THEIS <br />ISNAMEDASADDITIONALINSUREDANDENDORSEDACCORDINGLY. <br />ORANGECOUNTYPOLICY <br />4372 104 <br />EIC <br />ENDORSEMENT <br />ID: <br />CERTIFICATEHOLDERCANCELLATION <br />ORANGECOUNTY <br />SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORE <br />8181 <br />POBOX <br />THEBE <br />EXPIRATIONDATETHEREOF,NOTICEWILLDELIVERED <br />ACCORDANCEWITHTHEPOLlCYPROVISIONS. <br />N.C. <br />HILLSBOROUGH, <br />AUTHORIZEDREPRESENTATIVE <br />JENNYLHARRISON <br />ACORDCORPORATION.Allrightsreserved. <br />ACORD25(2014101) <br />TheACORDnameandlogoareregisteredmarksofACORD <br />ProducedusingForm;80ssPlussoftware.w.YW.FormsBoss.com;IrrpressivePutiishing800-208-1977 <br /> <br />