Orange County NC Website
Browse       Search
DocuSign Envelope ID: 16C356ED-33DB-4FF4-AF30-05049A4F50B1 <br /> '4�°R°® CERTIFICATE OF LIABILITY INSURANCE DATE(kBAJDOIYYTT) <br /> 2/1/2016 _ <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(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les)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 ondorsoment(s). <br /> PRODUCER CONTACT Lynn Linderman <br /> The Mechanic) Group PHONE (895)735-0700 Fp x <br /> AIC.IIo.E,Ln: 1 ra,No):(0461735-OM <br /> One Blue Hill Plaza �'!'V" llindermanOmechanic rou <br /> Suite 530 ADDRESS: <br /> 9 p+cOm <br /> INSURER(s)AFFORDING COVERAOE + NAM/ <br /> Pearl River NY 10965 IyS ERAAIlied World Surplus Lines 29319 <br /> INSURED <br /> IHsuRERB:Hartford Fire Insurance Co, 19602 <br /> Southeastern Security Consultants' Ina INsuRERC;Twin City Fire Insurance Co. 29959 <br /> 1853 Piedmont Road INSURER D I <br /> Suite 100 <br /> INSURER EI <br /> Marietta GA 30066 IHSURERF I <br /> COVERAGES CERTIFICATE NUMBER:2016-2017 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE PEEN 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 HE 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 /> MR TYPEOFINSURANCF: ADOLISUDIf ` POLICY REP PpOLICYyEXP " <br /> HisR VND., POLICYNUJAURR IMMIPP YYYYI JMM!ODJYI'YYI, LIMITS <br /> GENERAL LABILITY EACH OCCURRENCE $ 1,000,000 <br /> UAdAOETORENTED <br /> ` X CO1tERCIAL GENERAL LIAUIUTY PREMISES(Eta oecane <br /> ne@) $ 100,000'` I/ . _ X <br /> CLAWS MADE: I i OCCUR X 5200^0189-03 2/19/2016 2/14/2017 MEOFXP(Anjcnepereon) $ 10,000 <br /> X Errors L Omieaiona PERSONAL&ADVINJURY $ 1,000,000_ <br /> GENERAL AGGREGATE $ 3,000,000 <br /> ' GEM.AGGREGATELIIATAPPLIESPER: PRODUCTS•COMP/OPADO $ 3,000,000 <br /> ' X1 POLICY n pa <br /> _ � Floc <br /> s <br /> ' AUTOMOBILE LIABILITY 'COMBINED ISINGLELIMIT $ 500,000 <br /> TER B X ANYAUID <br /> SCHEDULED 16USCBIe e2 2/19/2016 2/14/2011 DODILYINJURY(Per person) $ <br /> UODILY INJURY(Peracdenq $AUTOS AUTO <br /> X HIRED AUTOS X- A N-O?,1ED FpRROPERIY DAMACE $ <br /> lPor ect denll <br /> S <br /> UMBRELLA Lute OCCUR ^EACH OCCURRENCE '$ • <br /> EXCESS LIA4 AGGREGATE $ <br /> I. DEO I I RETENTIONS S <br /> O WORKERSCOMPENSATION 14CTA'IU- OTH- <br /> AND EMPLOYERS'LIABILITY YIN <br /> X ITO; - + <br /> ) _ ANY PROPRIErorbPARTNErvExECUTIVE EACH ACCIDENT $ 100,000 <br /> OFFICERRAEMEER EXCLUDED? (x J N E.L. <br /> �I, (Mandatory In NH) 161TECO13956 2/14/2016 2/14/2017 EL DISEASE EA EMPLOYEE S. 500 000 <br /> I( os do5cnty under , <br /> L4F UscEIPTION OF OPERATIONS ue:av <br /> E.L DISEASE•POLICY UNJT $ 100,000 <br /> CG <br /> I <br /> DESCRIPTION OF OPERAT1ONS(LOCATIONS TVEHLCLES(Allach ACORD 101,Addillonal Remarks Schodui4,If more space Is required) ' <br /> VTith respect to the Commercial Liability plan referenced, the below noted entities are inoluded as <br /> 'Additional Ensured per Endorsement II CO 2010 (07/09) Additional Insured - Owners, Lessors, or <br /> Contractors- Schedule Person or Organization. <br /> Orange County, its officers, official agents and employees <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attn: Risk Management <br /> 200 South Cameron Street AUTHORI2EDREPRE$ENTA11VR <br /> PO Box 8181 <br /> l Hillsborough, NC' 27278 y <br /> Steve Meohanio/LYNN <br /> • <br /> ACORD 26(2010/05) ©1988-2010 ACORD CORPORATION, All righis reserved. <br /> INSO251901e15101 The Acorn)name And Irma era ranI.larprl marks Af GRr1RPf <br /> l <br />