Orange County NC Website
Browse       Search
DocuSign Envelope ID: 3D33619A-OD44-4FDD-8749-BC3C4975OD59 <br /> CERTIFICATE OF LIABILITY INSURANCE R022 [3728/2016 <br /> THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED,subject to the <br /> 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 /> WELLS FARGO INS SVCS USA INC/PHS (A"/C,N,E)a): (866) 467-8730 ia,Na>: (888) 443-6112 <br /> 715776 P: (866) 467-8730 F: (888) 443-6112 A'DDR`ESS: <br /> PO BOX 29611 INSURER(S)AFFORDING COVERAGE NAIL# <br /> CHARLOTTE NC 28229 INSURERA: Hartford Casualty Ins Co 29424 <br /> INSURED <br /> INSURER B: <br /> INSURER C: <br /> SWANSON&ASSOCIATES PA INSURER D: <br /> 100 E CARR ST INSURER E: <br /> CARRBORO NC 27510 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 <br /> TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INNR TIPEOFINSUR-1NCE ADDL SUBR POLICYN17,1IBER POLICYEFF POLICYEYP L731ITS <br /> IAI/DDAIII <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 62,000 000 <br /> CLAIMS-MADE OCCUR PR SES Ea occurrence) 5300,00 <br /> A X General Liab 41 SBA PS6105 06/01/2015 06/01/2016 MED EXP(Any one person) $10 000 <br /> PERSONAL&AIN INJURY s2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s4,000,000 <br /> POLICY IEC LOC PRODUCTS-COMP/OP AGG A 000 000 <br /> OTHER: S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) $ <br /> ANY AUTO BODILY INJURY(Par person) $ <br /> ALL j SCHEDULED <br /> AUTAUTOS BODILY INJURY(Per accident) $ <br /> HIRENON-OWNED PROPERTY DAMAGE <br /> AUTOS (Per accident) $ <br /> UMB OCCUR EACH OCCURRENCE $ <br /> EXCCLAIMS-MAE AGGREGATE DEC $ <br /> 117IR%EB.S COMPEN&A TION PER OTH- <br /> ANDEd)PLOYERS'LUBILITY STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) F] E.L.E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 181,Additional Remarks Schedule,may be attached if more space is required) <br /> Those usual to the Insured's Operations. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> 7 TT�i �7 DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, <br /> ORANGE CO V NT 1 AUTHORIZED REPRESENTATIVE , <br /> PO BOX 8181 <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 />