2016-478-E DSS - The Dispute Settlement Center, Inc. for dispute resolution

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DocuSi n Envelo e ID:BC6E8913-CCF6-4358-9785-EOFD20F10E29 a RIJ CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDOIYYYY) 1/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Crystal Ireland Business Insurers of Carolinas PHONE (919)968-4611 I FAX,Nol:(915)568-8591 INC.Nn.Ertl__W800 Eastowne Drive, Suite 208 IL :cirelandwzbusiness-insurers.com —.... PO Box 2536 INSURERISI AFFORDING COVERAGE NAIC 4 NC 27515-2536 INSUREBA:Hamilton Mutual Insurance Co 14125 Chapel hill y . ' INSURED INSURER s Employers Mutual Casualty 21415 DISPUTE SETTLEMENT CENTER INC INSURER C: -.°.°.-,..._. 302 W WEAVER ST 8TE A INSURER D INSURER E: -- - ._.,_..............-- - CARRBORD NC 27510-6004 INSURERF: COVERAGES CERTIFICATE NUMBER:CL156313007 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTMTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLIC4ES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID „.CLAIMS. MR _. ...---AlIZE Ugl2_ . POLICYEFF � YI POLICY E7cI _-.___ LILIMITS .,_....-.._...._°.._ -` LTR TYPE OF INSURANCE IMVD POUCY NUMBER (MM/DDIYYYY) (MM/DDIYYY . X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000'000,000 INTl E7 A CLPJMS-MADE I7{JOCCUR PREMISES fEaoc4¢!?N(L:I?1____..S 300,000 4W54457 6/17/2015 6/17/2016 MF_i)E%P(Any one pYrxerr) S 5,000 PERSONAL&ADV INJURY 5 GEIIL AGGREGATE LIMIT APPLIES PER: GENERA!-AGGREGATE S _ X POLICY r.7£CT j LOC PRODUCTS-COMP/OP AGG 5 2,000,000 HiedPoorrcwed 5 1,000,000 l COMB NFi:'1N6 LIMIT S AUIrOMoniLP LIAr11LYrr Ea accident; I ANY AUTO BODILY NJURY(Per person) $ 111 PROPERTY DANAC,Eadent)'I$ `^-��- ALLOS SCHEDULED IAUTOS _ NON-U (Per accident) .. .,_..,,._°..,_. 1 HIRED AUTOS AUTOS $ UMBRELLA LIAR I OCCUR i ',EACH OCCURRENCE E.. EXCESS LIAB CLAIMS-MADE AGGREGA-E $ , DED RETENTION$ I S WORKERS COMPENSATION ...... x__STATUTE I I ERA I ... AND EMPLOYERS LWBIIJTY Y I N AM'PROPRIETORIPARTNER/EXECUTIVE I N/A E,L.EACH AL:CIDEN I !S 100,000 OFFIratorin NH) 41154487 6/17/2015 6/17/2016 F DSEASE-EA EMPLOYE $ 100,000 B (Mandatory in NH) --.. •° Pr Yes.derlalbe Lnder DESCRIPTION OF OPERATIONS below E_L U!3EASE-POLICY UM T $ 500,000 ° DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AM:Rimed imed Remarks Schedule,maybe attached C more space Is required) CERTIFICATE HOLDER CANCELLATION jethompson @orangecountync. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION ON TH POLICY THEREOF, NI TICE WILL BE DELIVERED EN PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE / C Ireland/IRELO1 � �awwrlGJ al 1988-2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INSO25!9014011