Orange County NC Website
DocuSign Envelope ID: D3681F3B-8C57-4991-949F-E667356D92FF <br /> `' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYIr) <br /> 04/25/2017 <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 the <br /> 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: Will Brame <br /> Will Brame,Agent PHONE FAX <br /> AA/c No xtt <br /> E : 828-738-5653 (A/C,No): <br /> Walker Insurance Group E-MAIL <br /> ADDRESS: wbrame@aiinus.com <br /> 430 East Williams Street <br /> Apex,NC 27502 INSURER(S)AFFORDING COVERAGE NAIL# <br /> INSURER A: Essex Insurance Company 39020 <br /> INSURED <br /> Apex Fire Systems INSURER B: Auto Owners Insurance 18988 <br /> PO Box 879 INSURER c: Riverport Insurance Company 36884 <br /> Sanford,NC 27331 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:42517 REVISION NUMBER: 1 <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 <br /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DDYYEYYY) (MMID YD/YY EXP LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE $2 000 000 <br /> X COMMERCIAL GENERAL LIABILITY � FT- DAMAGE TO RENTED <br /> I 1 PREMISES(Ea occurrence) $ 100,000 <br /> CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000 <br /> A 3AA103647 08/28/2016 08/28/2017 PERSONAL&ADV INJURY $2000,000 <br /> GENERAL AGGREGATE $4,000,000 <br /> GEN'L AGGREGATE LIMIT APPUES PER: PRODUCTS-COMP/OP AGG $4.000,000 <br /> X <br /> POLICY PRO- <br /> ....... JECT LOC $ <br /> AUTOMOBILE LIABILITY [i COMBINED SINGLE LIMIT <br /> (Ea accident) $ 1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> X AUTOS OWNED SCHEDULED <br /> B 50-462-480-00 08/27/2016 08/27/2017 BODILY INJURY(Per accident) $ <br /> X HIRED AUTOS NON-OWNED <br /> PROPERTY DAMAGE $ <br /> AUTOS <br /> (Per accident) <br /> UMBRELLA LIAB OCCUR ' EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE <br /> DED RETENTION$ <br /> WORKERS COMPENSATION $ <br /> AND EMPLOYERS'LIABILITY y/N X TORY L MITS OER <br /> C ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICE/MEMBER EXCLUDED', N N/A 6605626 08/28/2016 08/28/2017 E .EACH ACCIDENT $ 1,000,000 <br /> (Mandatory in NH) E .DISEASE-EA EMPLOYE: $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OFOPFRATIONS below E .DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) <br /> FIRE PROTECTION SALES,INSTALLATION,AND SERVICES <br /> AUTOMOBILE AS IT PERTAINS TO THE NAMED INSUREDS OPERATIONS IN CONNECTION WITH THE ABOVE <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> PO BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> HILLSBOROUGH,NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> 919-732-8181 <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />