Orange County NC Website
®DocuSign Envelope ID:2A7B8A99-FCBE-440E-A69D-35417F3FA2A5 <br /> i�1 DRAPADE-01 KCOLLINS <br /> ACORL,° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> `--■" 8/17/2016 <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 policy(ies)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 endorsement(s). <br /> PRODUCER CONTACT I'. <br /> NAME: <br /> Ames&Gough PHONE 703 827-2277 Fax 703 827-2279 <br /> 8300 Greensboro Drive (A/C,No,Ext): <br /> ( ) (A/c,No):( ) <br /> Suite 980 ADDRESS:admin @amesgough.com <br /> McLean,VA 22102 <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Continental Casualty Company(CNA)A,XV 20443 <br /> INSURED INSURER B: <br /> G <br /> Draper Aden Associates,Inc. INSURER C: <br /> 2206 South Main Street INSURER D: <br /> Blacksburg,VA 24060 INSURER E: <br /> INSURER F: _ <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 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 BE 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP <br /> INSD WVD POLICY NUMBER (MMIDD/YYYY) (MM/DD/YYYY) LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED <br /> 9 PREMISES(Ea occurrence) $ I; <br /> MED EXP(Any one person)_ $ <br /> PERSONAL&ADV INJURY $ <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ <br /> POLICY JEr LOC PRODUCTS-COMP/OP AGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY ' COMBINED SINGLE LIMIT $ <br /> (Ea accident) _ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS (Per accident) <br /> $ <br /> UMBRELLA LIAB OCCUR CACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE _ $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER - <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Professional Liab. AEH288351149 05/14/2016 05/14/2017 Per Claim Limit 5,000,000 <br /> A Professional Liab. AEH288351149 05/14/2016 05/14/2017 Annual Aggregate 10,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> • <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> FOR PROPOSAL PURPOSES ONLY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE , <br /> I <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />