Orange County NC Website
DocuSign Envelope ID: 3A31 B022-AB07-46B8-BD87-EE8709D861 OE <br /> A�° CERTIFICATE OF LIABILITY INSURANCE DATE(M MIDDfYYYY) <br /> 08107/2015 <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 INSURERS), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) 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; Charlie Dickerson <br /> The Insurance Pros.Inc. PHONE IV <br /> 1210 Cole Mill Road Alc o Ext 919 294-6613 we No: 866 294-9470 <br /> E-MAIL <br /> Suite 101 ADDREss:chariie insurance rosonline.com <br /> Durham,NC 27705 INSURERS AFFORDING COVERAGE NAIC H <br /> INSURERA:Erie Insurance Exchange <br /> INSURED INSURERn:Erie Insurance Exchange <br /> Fortress Fencing,LLC Erie insurance Exchange <br /> Po Box 1377 INSURER C <br /> Carrboro,INC 27510-3377 INSURER 0:Insurance Solutions <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 /> INSR TYPE OF INSURANCE ADDL SU D POLICY NUMBER MAMIDDNYYY MM7�ONYYY LIMITS <br /> LTR <br /> A X COMMERCIAL GENERAL LIABILITY Q382250720 2122/2015 2/22/2016 EACH OCCURRENCE $ 1000000 <br /> DAMAG MIMS-MADE ❑X OCCUR PREM SESOEaEocc ante $ 1000000 <br /> MED EXP(Any one person) $ 5000 <br /> PERSONAL&ADV INJURY $ 1000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 <br /> X POLICY❑PRO JECT ❑LOC PRODUCTS-COMPIOP AGG $ 2000000 <br /> OTHER $ <br /> B AUTOMOBILE LIABILITY Q022240032 2/22/2015 2122/2016 Ca MI1,1 1NGLE LIMIT $ 1000000 <br /> X ANYAUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> X HIRED AUTOS )( NON-OWNED PROPERTY DAMAGE S <br /> AUTOS Per accident <br /> S <br /> C UMBRELLA LIAB x OCCUR Q262270226 2/22/2015 2/22/2016 EACH OCCURRENCE S 1000000 <br /> X EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1000000 <br /> DEG 1 0 1 RETENTIONS $ <br /> D WORKERS COMPENSATION WCIOO-0007808-20:14A 3/9/2015 3/9/2016 X I STATUTE RTH <br /> AND EMPLOYERS`LIABILITY <br /> Y <br /> ANY PROPRIETORIPARTNER(LXECUTIVE � NIA <br /> E.L.EACH ACCIDENT S 1000000 <br /> OFRCERIMEMBER EXCLUDED? <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1000000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POCKY LIMIT 1$ 1000000 <br /> E <br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES (ACORD 101,Additlanal Remarks Schedule,may be atlached If more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> ORANGE COUNTY DEAPR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> PO BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> HILLSBOROUGH NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD <br />