Agenda - 07-07-1986 - Laserfiche WebLink

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Certificate of Insuranc =or THIS£ERTIFICATE 1515511W AS-A SMATTER.-OF:INFORMATION 'ONLY AND'('CONFERS NO-RIGHTS UPON THE CERTIFICATE HOLDER • -.'''•-THIS-CERTIFICATE=DOES'NOT a1MEND,=EXTEND"'OR :ALTER=THE:COVERAGE AFFORDED BY THE POLICIES_LISTED-BELOW. - NAME AND ADDRESS OF AGENCY Ballard Agency, Inc. COMPANIES AFFORDING COVERAGES P. O. Box 927 Hillsborough, N. C. 27278 ETTERNY A COMPANY LETTER B The Standard Fire Ins. Co. NAME AND ADDRESS OF INSURED Richard William Jones LETTER"Y C 320 West 'Corbin Street Hillsborough,N. C. 27278 COMPANY D LETTER COMPANY E LETTER This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. Notwithstanding 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 policies. COMPANY TYPE OF INSURANCE POLICY NUMBER POLICY Limits of Liabilit in Thousands(000) LETTER EXPIRATION DATE EACH OCCURRENCE AGGREGATE GENERAL LIABILITY BODILY INJURY S E B 000MPREHENSIVE FORM Q25 CO 69811 CCS 8`2/i R-86 ❑PREMISES—OPERATIONS �7 PROPERTY DAMAGE $ $ ❑EXPLOSION AND COLLAPSE HAZARD ❑UNDERGROUND HAZARD ❑PRODUCTS/COMPLETED " ❑ OPERATIONS HAZARD BODILY INJURY AND CONTRACTUAL INSURANCE PROPERTY AAGE l I P ,0 0 0 20 0 000 COMBINED ❑ BROAD FORM PROPERTY V Y DAMAGE - ❑ INDEPENDENT CONTRACTORS ❑ PERSONAL INJURY PERSONAL INJURY E • AUTOMOBILE LIABILITY BODILY INJURY (EACH PERSON) ❑ COMPREHENSIVE FORM BODILY INJURY s El (EACH ACCIDENT) ❑ HIRED PROPERTY DAMAGE $ • ❑ NON-OWNED BODILY INJURY AND - PROPERTY DAMAGE COMBINED EXCESS LIABILITY BODILY INJURY AND ❑ UMBRELLA FORM PROPERTY DAMAGE $ $ ❑ OTHER THAN UMBRELLA COMBINED -� FORM WORKERS'COMPENSATION . STATUTORY and EMPLOYERS'LIABILITY OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES Hillsborough, North Carolina and elsewhere in North Carolina Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com- pany will endeavor to mail -1..d_ days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: Orange Housing & Communit Y men Develo t E ISSUED.— 615�a6 p 300 West Tryon Street , Hillsborough, N. C. 27278 _-.'- f� �d�i/, /` T kE� ACDRD 25(1.79)