Orange County NC Website
Browse       Search
DocuSign Envelope ID:2A1075EC-EE19-45F1-824C-C040EDA1A3FF <br /> -..— CAROLGI OP I11:JC <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDrrM) <br /> 16- /1106/2015 <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(€es) 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 Victor P.Cope <br /> Lowry,Cope&Little PHONE FAX <br /> P.O.BOX 30517 Arc No Ext FAX rdc No): 704-943-0692 <br /> Charlotte,NC 28230 <br /> E-MAIL SS!VCOPe@lowryassoc.com <br /> Victor P.Cope <br /> INSURER($)AFFORDING COVERAGE NA[C# <br /> INSURERA:Builders Mutual Ins Co <br /> INSURED Carolina Green Corporation INSURER B:Texas Mutual Insurance Co <br /> Kerry Price INSURERC: <br /> 10108 Indian Trail Fairview Rd <br /> Indian Trail,NC 28079 INSURERD: <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 /> INSR1 LT. TYPE OF INSURANCE INSR S B POLICY NUMBER M N,,,YYY M°pY1YYYY LIMITS WVn)LTR <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGETO ENT <br /> COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence)$ <br /> CLAIMS-MADE [A OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $ <br /> POLICY PRO- LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident -§— <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALLOWNED SCHEDULED BODILY INJURY(Per accident) S <br /> AUTOS AUTO-OS PROPERTY DAMAGE $ y <br /> HIRED AUTOS AUTOS AEFR ACCIDENT) <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION S $ <br /> WORKERS COMPENSATION X TWOCRSTATU- OT,ZH- <br /> AND EMPLOYERS'LIABILITY <br /> A ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ NIA CP1042087(NC&SC) 11/0112015 11/01/2016 E.L.EACH ACCIDENT $ 600,00 <br /> OFFICER/MEMBER EXCLUDED? <br /> B (Mandatory In NH) 003417849(TX) 11/0112015 11/01/2016 E.L.DISEASE-EA EMPLOYEE $ 600,00 <br /> If es,desonbounder <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 <br /> DESCRIPTION OF OPERATIONS r LOCATIONS I VEHICLES(Attach ACORD TOf,Addltlonal Remarks Schedule,It more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Parks& THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g Y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Recreation <br /> 6823 Millhouse Road AUTHORIZED REPRESENTATIVE <br /> Chapel Hill,NC 27516 Victor P.Cope <br /> O 1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2010(05) The ACORD name and logo are registered marks of ACORD <br />