Orange County NC Website
DocuSign Envelope ID: B840BD77-8346-41AC-85B4-37D8F3A6OB7A <br /> CERTIFICATE OF LIABILITY� DATE(MMrDDrYYYY) <br /> INSURANCE 05/09/2016 <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($), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poiicy(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 3Reu of such endorsement(s). <br /> PRODUCER ...�..... CONTACT Will Brame. <br /> NAME: _ <br /> Will Brame Assoc.Agent PHONE 919-362-8042 Fax <br /> _(sfxfC�Ja Ex4) <br /> Walker Insurance Group E-MAIL <br /> ADDRESS: wbrame@aiinus.com <br /> .� <br /> 420 East Williams Street 1, URER(S)AFFORDING COVERAGE �NAIC <br /> Apex,NC 27502 INSURERA: Essex Insurance Company 39020 <br /> INSURED INSURER B. Auto Owners insurance <br /> Apex Fire Systems INSURERC: Riverport Insurance Company 1 36684 <br /> _ _.._...__...._ <br /> PO Box 879 INSURER D: <br /> _................._ _.........._._..... <br /> ._.._._ <br /> Sanford,NC 27331 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,TERN/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 ADLSUBR <br /> POLICY Ef POLICY EX <br /> LTD ._ ..__......__-- <br /> TYPE OF INSURANCE R POLICY hNUMBER MPoAfDD1°dYYY I. MitL}L?P(YYY LIMITS <br /> GENERAL LIABILITY 2,000,000 <br /> �,+ EACH OCCURRENCE $ <br /> ✓! COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED ..— <br /> $ 100 000 <br /> PREMISES Eaaccurrance) <br /> CLAIMS-MADE � OCCUR � MED EXP(Any,one ppfson)_k S 5 000... <br /> A 3AA103647 08/2812015 08/28/2016 2000 000 <br /> _w ( PERSONAL&AOV INJURY I$ <br /> _ - <br /> s jGENERALAGGREGATE 4,000,000 <br /> GE.N'L AGGREGATE LIMIT APPLIES PER' =PRODUCTS-COMPIOP AGG .i 4,000,000 <br /> _i PRO- <br /> POLICY LOC --- $ <br /> E AUTOMOBILE LIABILITY i i }ct7MaINE2S SINGLE LIMIT <br /> $ 1,0©0,p00 <br /> Li�, , I{Ea accident _, <br /> ANY AUTO 1 ` BODILY INJURY(Per person) S <br /> r ALL OWNED t SCHEDULED 50-462-480-00 !08/27/2015�08/27/2016(BODILY INJURY(Peracddent) .$ .... .�,...,_... _ <br /> AUTOS AUTOS _. <br /> I NON-OWNED I PROPERTY DAMAGE ---------- <br /> fit^ <br /> HIRED AUTOS /AUTOS i Peraecidenk} 5 <br /> $ <br /> UMBRELLA LIAR <br /> �I OCCUR EACH OCCURRENCE ;$ <br /> ExOE55 LIAR CLAIMS-MADE AGGREGATE € <br /> I DED RETENTIONS � --- --�$��-� <br /> WORKERS COMPENSATION I WC STATU l OTH- <br /> AND EMPLOYERS`LIABILITY i T R`�.I.[MIT$.( ER .._.. <br /> YINI _. <br /> ANY PRGPRIETOR/PARTNERtEXECU7IVE E.L.EACH ACCIDENT 3 1,000,00() <br /> C OFFICERIMEMBER EXCLUDED? I N JI N I A 6605626 08/2812015 08/2812016 — — <br /> '(Mandatory in NH) ` E;L_DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under <br /> !DESCRIPTION OF OPERATIONS below E .DISEASE.-POLICY LIMIT 5 1,000,000 <br /> i <br /> i <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,it more space Is requires!) <br /> Fire Alarm Sales,Installation,and Service - <br /> Automobile as it pertains to the named insureds operations in connection with the above <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES HE 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 /> 91.9-732-8181 AUTHORIZED REPRESENTATIVE <br /> I <br /> ACORD 25(2010105) O 1988-2010 ACOIREPeIMPORATION. All rights reserver!. <br /> The ACORD name and logo are registered sparks of ACORD <br />