Orange County NC Website
DocuSign Envelope ID:2472E8AE-3F95-4B92-B6CF-9B11 F6EF6E7E <br /> ACOR2? CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 01/23/2017 <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 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 <br /> NAME: <br /> Marsh Sponsored Programs PHONE FAX <br /> Sponsored No,Ext):8 0 0-33 8-13 91 (A/C,No):f -621-3173 <br /> a division of Marsh USA Inc. E-MAIL <br /> PO Box 144(14 ADDRESS:ace col ient request @rnarsh.corn <br /> Des Moines IA 50306 INSURER(S)AFFORDINGCOVERAGE NAIC# <br /> INSURER A:Hartford Accident & Indemnity Co 22357 <br /> INSURED INSURER B:Sentinel Insurance Company Ltd 11000 <br /> Reece Noland & McElrath Inc. <br /> INSURER C: <br /> 94 Main St. <br /> Canton, NC 26+716 INSURERD: <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 ADDL SUBR POLICY EFF POLICY EXP <br /> TYPE OF INSURANCE <br /> LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS <br /> A GENERAL LIABILITY 84SBWVM4602 11/G1/2G16 11/G1/2G17 EACH OCCURRENCE $1,000,000 <br /> Prof.Liab. Excl. DAMAGE TO RENTED <br /> COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $1, ,U U U <br /> NECLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,UM) <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,UUU,U U U <br /> PRO- <br /> POLICY X JECT LOC <br /> 4SBWVM4602 11/01/2016 11/01/2017 COMBINEDSINGLELIMIT <br /> A AUTOMOBILE LIABILITY (Ea accident) <br /> ■ ANY AUTO BODILY INJURY(Per person) $ <br /> ■ ALL OWNED ■ SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> IIINON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS (Per accident) <br /> ■ $ <br /> A • UMBRELLA LIAB X OCCUR 44SBWVM4602 11/01/2016 11/01/2017 EACH OCCURRENCE $1,(1(1(1,(1(1(1 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 <br /> DED ® RETENTION$1u,UUU $ <br /> B WORKERSCOMPENSATION U4WBGBA2UU7 11/01/2016 11/01/2017 x WCSTATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $500,0 0 0 <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $5 U U,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $5 U U,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County <br /> AUTHORIZED REPRESENTTAATIVE <br /> PO Box 8181 Q (P <br /> Hillsborough, NC 27278 . VVV <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />