Orange County NC Website
DocuSign Envelope ID:4BF8C3BA-4757-4FOB-8317-A8F20AEF7Al2 <br /> ��® ®® r ATE(MM/DD[YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 08/19/2015 <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 NAME CT Louise Churchill <br /> Hefting &Bickers Insurance Agency A/C CNN Ext: (AIC.No). (919)479-1868 <br /> 2344 Operations Drive E_DDRESS: <br /> Suite 101 NSURER(S)AFFORDING COVERAGE NAIC# <br /> Durham NC 27705 INSURER A: HARTFORD CAS INS CO 29424 <br /> INSURED INSURER B: Erie Insurance Exchange 26271 <br /> Signs Now/Occasions Engraving,Stokes Inc dba INSURER C <br /> 1322 Fordham Blvd INSURER D: HARTFORD UNDERWRITERS INS CO 30104 <br /> _ INSURER E: <br /> Chapel Hill NC 27514 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 POLICY EFF POLICY EXP <br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDNYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 <br /> CLAIMS-MADE � PREMI SES S OCCUR DAMAGE REMISES TED 1000000 <br /> PREMI Ea occurrence) $ <br /> MED EXP(Anyone person) $ 10000 <br /> A N N 22SBAUC3584 08110/2015 08/10/2016 PERSONAL&ADV INJURY $ 1000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 <br /> X <br /> POLICY F—]P.ERCT FI LOC PRODUCTS-COMP/OP AGG $ 2000000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> B ALL OWNED SCHEDULED N N Q09-0630393 09/06/2014 09/06/2015 BODILY INJURY(Peraccident) $ <br /> AUTOS X AUTOS <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS (Per acadent) <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DIED I I RETENTION$ $ <br /> WORKERS COMPENSATION X STATUTE I OERH <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNERIEXECUTIVE Y/N E.L.EACH ACCIDENT $ 100000 <br /> D OFFICERIMEMBEREXCLUDED? Y�N/A N 22WECRH7577 08/10/2015 08/10/2016 <br /> (Mandatory In NH) E.L.DISEASE-EAEMPLOYEE $ 500000 <br /> Ifyes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 100000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) <br /> , <br /> i <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> PO Box 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> i <br /> AUTHORIZED REPRESENTATIVE i <br /> Hillsborough NC 27278 - <br /> Fax: Email: ®1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD <br />