Orange County NC Website
Browse       Search
DocuSign Envelope ID:33C88EF4-FFB2-404E-9835-D756AFACAOOD <br /> OP ID:C1 <br /> .4 I [AMR If7►"' DA FIE(MMIODBYYYY) <br /> .. CERTIFICATE OF LIABILITY INSURANCE 041291201; <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 IINSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER„AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder its 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 sloes not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PfxootacER NNAM cr Jack Sharon or Luey Holmes <br /> The Insurance Center of Durham ._. - _ ..... .. <br /> 1520 Front St.,Suite 710 i I N ) 9119 471 2641 _ _'[FAX No ):919-471-2132 <br /> P.O.Box 15369 E-MAIL Luc Ilnsurancecenterofdurharn corn <br /> Durham,NC 27704- PRODUCER <br /> Jack Sherron„CPCU CNSrgmt: HAIOLEI <br /> INISUEItt(SI,ArroRDING COVERAGE NAIC S <br /> INSURED Scott HaiglerE'Ie­ctric INSURFRA.Auto wvnersInsuranceCo. ....18'958.... <br /> 6616 Blalock Road - ----- — <br /> Bahama,NC 27.603 ilysula ;TravMXlers Insurance Co. (AWVCf <br /> IN§YRER C <br /> INSUSZER D <br /> INSURER E <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, NOTVVITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VIATH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY IBE 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 iNSURAA�NC.E.................__ CbISLL T3�R a74?L.IC'd NUMBER MMJDDJYYYY. MMPN,�t)�Y"YYY LIMITS <br /> GENERAL LIABILITY 4EACH OCCURRENCE $ 1,000,00 <br /> AVFM 't'CS TEGa _ _. <br /> A X. C'„OMMERCIALGENERAL LIAeLITY 135852'9913 09/1312014 0911'Sl2b1�a RLp a ��T acuaxgLrr�enR.. 5 100,4 <br /> CLAWS-MAOE L. ..I OCCUNR.' 4 Mr17 LXA IAYMY.aa1e per' rrt1,,,. $ ..5'0 <br /> PERSONAL&ADV INJURY $...._-. 1 000,000 <br /> All......, .......... .`.....��........ <br /> C,EN L AC;GRE,GATE LUMRT APPLIES PER � PRODUCTS-CCURIOP'AGG 'S 2,000,00 <br /> �RLT- $ <br /> c�TsLltty � Lets <br /> AUTOMOBILE LIABILITY COMBNED SINGLE UMLT` $ <br /> __... (Ea araRletlll <br /> ANYAUTO ... ._.... .......... .......................................... <br /> (----. ALII_.CIVVPWF.U:I AU7"Tf,Y:a" HC yDrl Y INJUR°d(Per F�R+�n) �S <br /> BS"J <br /> °IIL.Y INJUHY(Pef acadent) S <br /> SCHEMJLFD AUTOS ._.._.__._ <br /> .... PROPERTY DAMAGE ..... -.-. <br /> HIRI D AUTOS (PER ACCIDENT) <br /> NICYNIOVMM'"WECY AUTOS <br /> I S <br /> UMBRELLA LIAR OCCUR FA.CH CX.,CURF1CNICIF $ <br /> I EXCESS LIMB I CLAIMS.MADE AGGREGATE $ <br /> DEDU,E4.;n <br /> RETENTION $ $ <br /> W©RICERS COMPENSATION X w+aC%aTATU.J- I OTH. <br /> AND EMPLOYERS LIABILITY YIN T-Gl�"Y LIl1'IITr��r J. 1 .N. �----- ----- ------- --------- <br /> B A14Y I RCJPRIE5Tl,R:IIARTt�f-RJEXECU'tiVE�llll��lllll 'BJUBi5'033P61915 02/04/2015 02104/2016 E y-EACH ACC�UCETNT $ _ 100,00 <br /> L'PHCFRiNEMBEP EXCLUDED? Y NBA <br /> (Mandatory In NH) E IL.DISEASE-EA,EMPLOYEE s 100,000.- <br /> M1M es dpwnbe undor ... .... ....... ......... .........._ ....... .........,.. <br /> G.9 'iCRIP"TUON OF C,'WPE ATIONWS bebw E L,DISEASE-POLICY LUMIT $ 500,00 <br /> DESCRIP noN of OPERATIONS I LOCATIONS I VEHICLES(AtImeh ACO�RD 1e,1,Additionail Remarks Schedule,if mare space is required) <br /> ,ELECTRICIAN <br /> CERTIFICATE HOLDER. CANCELLATION <br /> ORAN016 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County THE EXPIRATION( DATE THEREOF, NOTICE, WILL BE DELIVERED IN <br /> C) <br /> g tY ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P'O Box 8181, <br /> Hillsborough,NC 27278 <br /> AU THORIGr°:ID REPRESENTATIVE <br /> Tack Sherron,CP'CU' <br /> I <br /> 01988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009109) The ACORD name and logo are registered)marks of ACORD <br />