Orange County NC Website
DocuSign Envelope ID:B3C559C7-669F-465A-9837-6178302D41F1 <br /> KIRKAPP-01 TSHANNON <br /> ACORN CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 04/01/2017 <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Tracey Shannon <br /> NAME: <br /> Rogers Insurance Agency PHONE FAX <br /> 512 W Williams Street (A/C,No,Ext):(919)362-8310 4095 (A/c,No):(919)362-4101 <br /> Apex,NC 27502 E-MAIL SS:tracey @rogersinc.net <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Auto-Owners Insurance Company 18988 <br /> INSURED INSURER B:CNN Continental Casualty Company 20443 <br /> Kirkland Appraisals,LLC INSURER C: <br /> 9408 Northfield Court INSURER D: <br /> Raleigh,NC 27603 <br /> 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 W POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSD VD (MM/DD/YYYY) (MM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR 35593104 01/11/2017 01/11/2018 DAMAGE TO RENTED 50 000 <br /> PREMISES(Ea occurrence) $ <br /> MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY <br /> PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER:General Aggregate $ <br /> A COMBINED SINGLE LIMIT <br /> AU LIABILITY <br /> (Ea accident) $ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY AMAGE <br /> AUTOS ONLY AUTOS ONLY (Per accident $ <br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 <br /> EXCESS LIAB CLAIMS-MADE 5059310400 09/15/2016 09/15/2017 AGGREGATE $ <br /> DED X RETENTION$ 10,000 $ 1,000,000 <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? N/A <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 /> B Errors&Ommission RFB-254141705-16 08/21/2016 08/21/2017 Per Claim/Aggregate 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Dept of Environment,Agriculture, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 9 Y p 9 , ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Parks and Recreation <br /> Attn: Rich Shaw <br /> 306A Revere Rd AUTHORIZED REPRESENTATIVE <br /> Hillsborough,NC 27278 611 <br /> 1. <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />