Orange County NC Website
DocuSign Envelope ID:4D07A756-4236-4526.A1D2-89F0777755FB ECSCARO1 <br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)5/04/2017 <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 , ),',OCT Meg S. Lee, CIC <br /> Andersen Insurance Group PHONE 703-988-0900 FAX Ext. 102 <br /> (A/C,No,Ext): (A/C,No): <br /> 5870 Trinity Parkway ADDRESS: meg@theandersengrp.com <br /> Suite 130 <br /> INSURER(S)AFFORDING COVERAGE NAIL# <br /> Centreville,VA 20120 INSURERA:Cincinnati Insurance Company 10677 <br /> INSURED INSURER B:Hartford Fire Insurance Company 19682 <br /> ECS Southeast, LLP INSURER C:Federal Insurance Company 20281 <br /> 14026 Thunderbolt Place Suite 500 <br /> INSURER D: •Y Hartford Casualty Insurance Co. 29424 <br /> Chantilly,VA 20151 <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 /> LTR L POLICY EFF POLICY EXP <br /> TYPE OF INSURANCE SR WVD POLICY NUMBER <br /> N LIMITS <br /> (MM/DDIYYYY) (MM/DDIYYYY) <br /> A GENERAL LIABILITY X X ENP0219991 12/01/2016 12/01/2017 EACH OCCURRENCE $1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISESO(Ea occurrence) $500,000 <br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000 <br /> X Contractual Liab PERSONAL&ADV INJURY $1,000,000 <br /> X X C U GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 <br /> 7 POLICY X PRO LOC $ <br /> JECT <br /> B AUTOMOBILE LIABILITY X X 42ABMS9642 12/01/2016 12/01/2017 Ea aBcdeDt)INGLE LIMIT $1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE <br /> AUTOS (Per accident) <br /> C X UMBRELLA LIAB X OCCUR X X 79891344 12/01/2016 12/01/2017 EACH OCCURRENCE $5,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 <br /> DED X RETENTION$0 $ <br /> D WORKERS COMPENSATION X 42WNMS9633 12/01/2016 12/01/2017 X TORY IMITS EORH <br /> AND EMPLOYERS'LIABILITY <br /> Y/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE All States Endt E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> A Excess Liability X X EXS0220000 12/01/2016 12/01/2017 $10,000,000 Limit <br /> Excess of$5,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> ECS job description: Orange County, NC Jail <br /> Certificate Holder is included as an Additional Insured on all policies except Worker's Compensation.All <br /> policies contain a waiver of subrogation in favor of the Certificate Holder. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> g y 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 /> ©1988-2010 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S230382/M223049 MEF <br />