Orange County NC Website
DocuSign Envelope ID:9DOB41F6-904D-44CF-95C3-DOC132794A57 <br /> 71/8/2016 TE(MM/DD/YYYY) <br /> ACC?" CERTIFICATE OF LIABILITY INSURANCE <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 Patty iller <br /> NAME: y <br /> HOE Business Insurers of Carolinas A/C NNo Ext: (919)968-4611 A/C No: (919)968-8991 <br /> Boo EastOWrie Drive, Suite 208 ADDRIESS:pom @business-insurers.com <br /> PO BOX 2536 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Chapel Hill NC 27515-2536 INSURERA:Union Insurance Company 25844 <br /> INSURED INSURER B:Stonewood Ins. Co. 11828 <br /> Corley Redfoot Architects, Inc INSURER C: <br /> 222 Cloister Court INSURER D: <br /> INSURER E: <br /> Chapel Hill NC 27514 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:CL161814323 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 SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE A CLAIMS-MADE � OCCUR PREM SESOEa occurrence)l $ 300,000 <br /> X CNA4298862 40 7/9/2015 7/9/2016 MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY❑ JECT PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> OTHER: Employment Practices Liab Ins $ 100,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> Ea accident <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> A ALL OWNED SCHEDULED <br /> X AUTOS X AUTOS CNA4298862 40 7/9/2015 7/9/2016 BODILY INJURY(Per accident) $ <br /> NON-OWNED PROPERTY DAMAGE $ <br /> X HIRED AUTOS X AUTOS Per accident <br /> Uninsured motorist BI split limit $ 11000,000 <br /> A X UMBRELLA LIAB X OCCUR CNA4298862 40 7/9/2015 7/9/2016 EACH OCCURRENCE $ 4 000 000 <br /> EXCESS LIAB CLAIMS-MADE Umbrella follows forms AGGREGATE $ 4,000,000 <br /> DED RETENTION$ GL,Auto & WC $ <br /> WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN <br /> STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 <br /> B OFFICER/MEMBER EXCLUDED? � N/A <br /> (Mandatory in NH) y WC1000002205 2014A 12/31/2014 12/31/2015 E.L.DISEASE-EA EMPLOYE $ 500 000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Orange County is included as additional insured in reference to the General Liability policy per written <br /> contract per attached policy forms CLCGO114, CLCG0472, CLCG2062. If subrogation is waived, subject to <br /> terms and conditions of the policy, certain policies may require an endorsement. A statement of this <br /> certificate does not conquer rights to the certifiate holder in lieu of such endorsements. <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 /> PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough, NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> Patty Miller/PATTY <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br /> INS025 rgmnm t <br />