Orange County NC Website
DocuSign Envelope ID:6E9B5308-6677-4F2E-9268-29D6E1A4FD76 <br /> �..�.� JOBRE-1 OP ID:S1 <br /> ACOR/�►� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) <br /> �.,..� 03/11/2015 <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 pollcy(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). I <br /> 0 IT <br /> PRODUCER NAME: DUPREE&WEBB INC <br /> Dupree&Webb,Inc. PHONE F <br /> PO Box 6522 WC.No Eat:919-828-3241 A/c N.!919-821-3911 <br /> Raleigh,NC 27628-6522 ADDRESS: <br /> Adrian B.Bond <br /> INSURER S AFFORDING COVERAGE NAIC p <br /> INSURER A-.Hartford Casualty Insurance Co _ 29424 <br /> INSURED JOB READY SERVICES,LLC INSURER B:Hartford Ins.Co.of Midwest 37478 <br /> 2300 WESTINGHOUSE BLVD#107 INSURER C.Evanston Insurance Company <br /> RALEIGH,INC 27604 <br /> INSURER D <br /> f <br /> INSURER E; <br /> INSURER F; <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 1 <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 h <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 /> QTR TYPE OF INSURANCE POLICY NUMBER MMID /YYYY MMID LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000:00 <br /> CLAIMS-MADE N OCCUR 22SBAIF7783 03101/2015 03/01/2016 PREMISES Ea occurrence $ 300,00 <br /> 00 <br /> MED EXP(Any one parson) $ i0,00( <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,0 <br /> PRO LOC <br /> - PRODUCTS-COMP/OPAGG $ 2,000,00 <br /> f <br /> ❑JECT <br /> POLICY <br /> HOTHER: <br /> AUTOMOBILE LIABILITY EA(EA SINGLE LIMIT $ 1,000,00 <br /> A ANY AUTO 22SBAIF7783 03/0112015 0310112016 BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> X HIRED AUTOS Ix NON-OWNEO PeracddentD GE $ h <br /> $ <br /> X UMBRELLA X OCCUR EACH OCCURRENCE $ 2,000,00 <br /> A EXCESS LIAB CLAIMS-MADE 22SBAIF7783 03101/2015 03/01/2016 AGGREGATE $ 2,000,00 <br /> DED X RETENTION <br /> WORKERS COMPENSATION X STA UTE ER AND EMPLOYERS'LIABILITY <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 22WBCE03770 03/01/2015 03/01/2016 EL EACH ACCIDENT $ 500,00 <br /> OFFICERIMEMBER EXCLUDEDI N/A <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 <br /> "P describe under 508 00 <br /> DE RIPTIO OF PERATIO S below E.L.DISEASE-POLICY LIMIT $ r <br /> C PROFESSIONAL LIAR SM906908 03/01/2015 03/01/2016 PER CLAIM 1,000,00 <br /> AGGREGATE 3,000,0 <br /> I <br /> DESCRIPTION OF OPERATIONS/LOCATIONS[VEHICLES(ACORD 101,Additional Remarks Schedule,may be'attached If more space Is required) <br /> I <br /> k <br /> CERTIFICATE HOLDER CANCELLATION <br /> JOBREAD <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> JOB READY SERVICES LLC <br /> 4 <br /> 2300 WESTINGHOUSE BLVD#107 AUTHORIZED REPRE NT <br /> RALEIGH,NC 27604 Adrian B.Bon <br /> 01988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD <br />