Orange County NC Website
DocuSign Envelope ID:867DEFE0-8479-4l E4-92D5-D9A2289F2942 <br /> 0 DATE(MMn3D1YYYY) <br /> A o CERTIFICATE OF LIABILITY INSURANCE <br /> 04/1912016 <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(les) must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does riot confer rights to the certificate holder In lieu of such endorsement(s). <br /> PRODUCER ONTA T <br /> NAME: Charlie Dickerson <br /> The Insurance Pros. Inc. PHONE 0191294-6613 FAX No: 866 234-9470 <br /> 1210 Cole Mill Road -MAIL <br /> SUile 101 ADDREss:Charlie insurance rosonline.com <br /> Durham,NC 27705 INSURER 5 AFFORDING COVERAGE NA1C# <br /> INSURERA:Erie Insurance Exchange <br /> INSURED INSURERe;Erie Insurance Exchange <br /> Fortress Fencing,LLC INSURERC:Erie InSU€ance Exchange <br /> Po Box 1377 <br /> Carrboro,NC 27510-3377 INSURER D:InSUraI1CC SDIUtiORS <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 /> INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY JYYYY P�MI�AIY YY LIMITS <br /> LTR <br /> A X COMMERCIALGENERAWABILITY Q382250720 2/22/2016 2/22/2017 <br /> EACH OCCURRENCE $ 1000000 <br /> CLAIMS-P.SADE OCCUR PREM SES EaLoccunDence S 1000000 <br /> MED EXP(Any one person) $ 5000 <br /> PERSONAL&ADV INJURY $ 1000000 <br /> GENL AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE $ 2000040 <br /> X POLICY❑PRO JECT 1-1 LOC PRODUCTS-COMPIOPAGG S 2000000 <br /> OTHER: $ <br /> B AUTOMOBILELIABILITY Q022240032 2/22/2016 2122/2017 EOP BI%EDSINGLELIMIT $ 1000000 <br /> I X X ANY AUTO BODILY INJURY(Per person) S <br /> OWNED SCHEDULED BODILY INJURY(Per accident) S <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPER,1 DAMAGE $ <br /> AUTOS ONLY X AUTOS ONLY Per acc dent <br /> $ <br /> C <br /> UMBRELLA LIAB X OCCUR Q262270226 2122/2016 2/22/2017 EACH OCCURRENCE $ 1000000 <br /> x EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1000000 <br /> DED 1 0 1 RETENTION$ $ <br /> D N10RKERS COMPENSATION WC100-0007808-2014A 3/0/2016 3/9/2017 X STATUTE EORH jPLR <br /> AND EMPLOYERS'LfABILITY <br /> AtJYPROPRIETOP/PARTNER/EXECUTiVE Y❑ NIA E.L.EACH ACCIDENT $ 1000000 <br /> OFFICER.I.IFM HER EXCLU DED? <br /> (Mandatory In NH) EL DISEASE-EA EMPLOYEE $ 1000000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS Wow E1.DISEASE-POLICY LIMIT S 1000000 <br /> E <br /> DESCRIPTION OF OPERATIONS I LOCATIONS IVEHICLES (ACORD 101,Additional Rernailks Schedule,may ba Attached If Moro space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> ORANGE COUNTY DEAPR 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 /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />