Agenda - 07-07-1986 - Laserfiche WebLink

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Y t T ♦ r Certificate of Insurance O(a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. ' THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. NAME AND ADDRESS OF AGENCY Ballard Agency, Inc. COMPANIES AFFORDING COVERAGES P. O. Boi 927 Hillsborough, N. C. 27278 E°nERNY A O COMPANY COMPA 4 LETTER B The Standard Fire Ins. Co. NAME AND ADDRESS OF INSURED Richard William Jones ETTERNY C 320 West 'Corbin Street • COMPANY p Hillsborough,N. C. 27278 LETTER COMPANY 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 polices described herein is subject to all the terms..exclusions and conditions of such policies. COMPANY TYPE OF INSURANCE POLICY NUMBER POLICY Lim is o Liability in Thousan•s(r'�T� LETTER EXPIRATION DATE 1111111.1111.1 EACH AGGREGATE OCCURRENCE GENERAL LIABILITY C BODILY INJURY S B 6]COMPREHENSIVE FORM a25 CO 69811 CCS 8-24-86 ❑PREMISES-OPERATIONS PROPERTY DAMAGE $ I ❑EXPLOSION AND COLLAPSE HAZARD ❑UNDERGROUND HAZARD ❑PRODUCTS/COMPLETED OPERATIONS HAZARD BODILY INJURY AND ❑CONTRACTUAL INSURANCE PROPERTY DAMAGE ry - ❑BROAD FORM PROPERTY - COMBINED 1 i , 0 O 2002000 DAMAGE ❑INDEPENDENT CONTRACTORS ❑PERSONAL INJURY PERSONAL INJURY S AUTOMOBILE LIABILITY BODILY INJURY (EACH PERSON) $ ❑ COMPREHENSIVE FORM - BODILY INJURY S ❑OWNED (EACH ACCIDENT) ❑ HIRED PROPERTY DAMAGE $ BODILY INJURY AND NON-OWNED PROPERTY DAMAGE $ EXCESS LIABILITY COMBINED BODILY INJURY AND • ❑ UMBRELLA FORM $ S PROPERTY DAMAGE ❑ OTHER THAN UMBRELLA COMBINED FORM WORKERS'COMPENSATION STATUTORY _ and EMPLOYERS'LIABILITY IIIIIIIIIIIIIII OTHER DESCRIPTION OF OPERATIONSJLOCATIONSIVEHICLES Hillsborough, North Carolina and elsewhere in North Carolina Cancellation: Should any of the above described polities be cancelled before the expiration date thereof, the issuing com- pany will endeavor to mail _la_ 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. • ti NAME AND ADDRESS OF CERTIFICATE HOLDER: - DATE ISSUED:Orange Housing $ Communi ty Development 300 West Tryon Street Hillsborough, N. C. 27278 i -RE • ACORD 25(1-79)