Orange County NC Website
Browse       Search
DocuSign Envelope ID 58340D10-53F7-460D-9D47-DA2ED9BEB980 <br /> "t*nanover 1902820 <br /> or <br /> .1,1 LE A - SCHEDULE OF UNDERLYING POLICIES <br /> d: TRIANGLE UROLOGY ASSOCIATES, <br /> and after: 06/25/2016 , 12:01 AM Standard Time <br /> is QD�-�80�G�9-Q3 <br /> ' <br /> 'CARRIER, POLICY NUMBER & PERIOD TYPE OF POLICY APPLICABLE LIMITS OR <br /> AMOUNT OF INSURANCE <br /> 1UOO <br /> Commercial 1,000,000 Each Duournencl <br /> ((a)Carrier: d <br /> Genera| Liabi|ih/ $ 2.l[D.ODO Genera| Agg'eQo <br /> WASSACHUSETTS BAY |NSUHANCE <br /> COMPANY Non-owned & 2,000,000 Product/Complet <br /> dAubm� Operations <br /> Policy 0D6-A005679'03 Hired Aggregate <br /> PV|icyPeriod: 00/25/2018 T(] 06/25/2017 <br /> Comprehensive Bodily Injury and Property <br /> (b) Carrier: AutompbUe Liability Damage Liability Combined <br /> � <br /> Each Accident <br /> Policy Number: Bodily Injury Person <br /> Policy Period: - EochAccident <br /> Property Damage <br /> � <br /> Each Accident <br /> (c)Carrier: Standard Workers Coverage B - Employers LiabiQ1 <br /> Compensation & Bodily by Accident <br /> ALLN\ERiCAF|N8NC|AL BENEFITS INSURANCE C Employers Liability $ 500.000 Each Accident <br /> Policy Number: VV26A00428803 <br /> Please Note: Bodi� ��rybyDisease <br /> Umbrella Coverage $ 500'000 Aggregate <br /> Policy Period: 06/25/2016 TO 06/25/2017 for Worke 500000 EVchEmp\oye' <br /> Compensation and <br /> Employers Liability <br /> is not applicable in <br /> situations where an <br /> employee is subject <br /> to the New York <br /> Workers <br /> Compensation Law. <br /> (d)Carrier: Liquor Liability Limit of Liabili <br /> Policy Number: <br /> Policy Period: <br /> (e)Carrier: Professional Limit of Liabil <br /> Liability <br /> Policy Number: <br /> Policy Period: <br /> An "X" marked in the box provided indicates these broadening or optional coverages are provided in the <br /> Underlying Insurance <br /> (f) Carrier: Directors & Officers $ Lim� ofLiabi <br /> � Liability <br /> Policy Number: <br /> Policy Period: <br /> Benefits $ Limit of(g) Employee Benefits nn� <br /> Liability <br /> Policy Number: <br /> Policy Period: <br /> Countersigned By: <br /> Date: <br /> Authorized Representative of the Company <br /> 473-1103 (11/08) <br /> 9,600 <br /> . -.--- <br />