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2015-537-E VB - Stemper Services dba Alicia Stemper Photography for OC Residents profile project
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2015-537-E VB - Stemper Services dba Alicia Stemper Photography for OC Residents profile project
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Last modified
8/19/2016 8:18:53 AM
Creation date
10/6/2015 9:44:51 AM
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Template:
BOCC
Date
10/5/2015
Meeting Type
Work Session
Document Type
Agreement
Agenda Item
Manager signed
Amount
$8,000.00
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R 2015-537-E VB - Stemper Services dba Alicia Stemper Photography for OC Residents profile project
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2015
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DocuSign Envelope ID: C6560E1 B-A276-4CE9-B3AO-COEDBE4BC76B <br /> STEMP-1 OP ID:MA <br /> CERTIFICATE OF LIABILITY INSURANCE <br /> DATE 09124/2 01 5 Y) <br /> � 09124!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 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 endorsements). <br /> PRODUCER NAME: Martin Hall <br /> Lee-Moore Insurance Agency Inc PHONE - FAX <br /> P.O.Box 667 _tAlcNo.ExtJ 919-932 9960 1(AIC No);919-933 0155_ <br /> West End,NC 27376 <br /> E MAIL <br /> Alex Malolo ADDRESS:leemoore.martin @gmaii.Com <br /> INSURERS/AFFORDING COVERAGE NAIC N <br /> INSURER A:AUTO-OWNERS INS.COMPANY 18988 <br /> --------------- ----- <br /> INSURED Stemper Services Inc INSURER B: <br /> Alicia Stemper - ---- <br /> 8107 KIT LIN INSURERC: <br /> CHAPEL HILL, NC 27516 INSURER D: <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 /> -- <br /> INSR ----------OF INS- ----AD-0 SUB-,---__—.— _-------- -- -----POLICY EFF POLICY EXP ----------.-._ .I..__-- <br /> LTR TYPE OF INSURANCE D POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> E ENTED <br /> R <br /> CLAIMS-MADE OCCUR 35318782 0410712015 04/07/2016 D Mai PREMISES(Ea occurrence) $ 50,00 <br /> MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 1,000,000 <br /> F-1 POLICY[ jE� LOC PRODUCTS-COMPIOPAGG S 1,000,000 <br /> —---- - -_ <br /> OTHER S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> __.. (Eaaccidenl)--_ _.-.. <br /> ANY AUTO BODILY INJURY(Per person) S <br /> ALL OWNED SCHEDULED <br /> _ AUTOS AUTOS + BODILY INJURY(Per accident) $ <br /> _-- NON-OWNED PROPERTY DAMAGE - - <br /> HIREDAUTOS AUTOS (Per-accdentl S <br /> $ <br /> UMBRELLA LIAR I OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR i CLAIMS-MADE I AGGREGATE <br /> DEC) RETENTION$ I $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN j._._ STATUTE _ <br /> - __ ER -- <br /> ANY PROPRIETOR/PARTNERIEXECUTIVE E,L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? F NIA ----- -- --- <br /> (Mandatory in NH) EL.DISEASE-EA EMPLOYEE S <br /> S,describe - `�----------- -------- --- -- - <br /> DESCRIPTION OF OPERATIONS below El.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schodulo,may bo attached if more space is required) <br /> photography <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g ty ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 S Cameron St <br /> Hillsborough,INC 27278 AUTHORIZED REPRESENTATIVs������/�� <br /> ©1988.2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />
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