Orange County NC Website
ACC>a CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY`/) <br /> 10/21/2015 <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 endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> Seagroves Agency,Inc PHONE <br /> No.Ext: (A/C,No <br /> 1506 E FRANKLIN ST E-MAIL <br /> STE 100 ADDRESS: <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> CHAPEL HILL NC 27514-2825 INSURERA: NATIONWIDE MUTUAL FIRE INSURANCE COMP/ 23779 <br /> INSURED INSURER B: <br /> OTIS KING JR INSURER C: <br /> DBA AOK LOCK SERVICE INSURER D: <br /> 3425 CHEEK RD INSURER E: <br /> DURHAM NC 27704-4947 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 ADDL SUBR POLICY EFF I POLICY EXP <br /> LTR TYPE OF INSURANCE IN D POLICY NUMBER MM/DD NIMIDONYrn LIMITS <br /> X COMMERCIAL GENERAL LIABILITY - EACH OCCURRENCE $ 100,000 <br /> CLAIMS-MADE X�OCCUR DAMAGE TO RENTE <br /> PREMISES Ea occurrence $ 100,000 <br /> MED IXP(Any one person) $ 5,000 <br /> A ACP GLGO 2273232612 05/03/2015 05/03/2016 PERSONAL 8 ADV INJURY $ 100,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 200,000 <br /> X POLICY❑J RD- LOC <br /> PRODUCTS-COMP/OPAGG $ 200,000 ECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY(Per accident) $ <br /> NON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS Per accident $ <br /> UMBRELLA LU18 OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE <br /> AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LWBILITY YIN STAME ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT <br /> OFFICER/MEMBEREXCLUDEDI ❑ N/A $ <br /> (Mandatory in NH) <br /> If yes,describe under E.L.DISEASE-EA EMPLOYEE $ <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <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 /> Orange County AUTHORIZED REPRESENTATIVE <br /> 131 W Margaret Lane Jean M Droese <br /> Hillsborough NC 27278 <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />