Orange County NC Website
DocuSign Envelope ID:E53B24FF-8900-482C-BC81-C6277D8784B3 <br /> DATE(MM/DD/YYYY) <br /> '`��RD® CERTIFICATE OF LIABILITY INSURANCE 6(MMIDD7 <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 ABD Insurance & Financial Services CONTACT Certificate Request <br /> 450 Sansome Street, #300 PHONE FAX <br /> San Francisco, CA 94111 (Mayo,Ext): 415-483-7770 (A/C,No): 415-483-7769 <br /> ADDRESS: CertRequest @theabdteam.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> www.theabdteam.com INSURER A: Hartford Fire Insurance Company 19682 <br /> INSURED INSURER B: <br /> Governmentjobs.com, Inc. NEOGOV) <br /> 222 N Sepulveda Blvd., #2000 INSURER C: Trumbull Insurance Company 27120 <br /> El Segundo, CA 90245 INSURERD: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 35993174 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 LIMITS <br /> LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) <br /> A / COMMERCIAL GENERAL LIABILITY ✓ 46 UUN KQ5028 8/25/2016 8/25/2017 EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO CLAIMS-MADE ,/ OCCUR PREMISES(Ea occur ence ) $ 300,000 <br /> MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADVINJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> ✓ POLICY JECT PRO LOC PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY 46 UUN KQ5028 8/25/2016 8/25/2017 COMBINED SINGLE LIMIT $ <br /> (Ea accident) 1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> ✓ AUTOS ONLY ✓ AUTOS ONLY (Per accident) <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> C WORKERS COMPENSATION 46 WE AR6243 8/25/2016 8/25/2017 ✓ O <br /> PERTUTE ETH <br /> AND EMPLOYERS'LIABILITY <br /> Y/N <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? 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 /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> RE:All Operations of the Named Insured. <br /> Orange County of(NC)is included as an additional insured as respects to General Liability, but only to the extent required by written contract or <br /> agreement. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Of(NC) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County (NC) THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> S <br /> 208 Cameron Street ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough, NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> mn <br /> } <br /> Rod Sockolov <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> 35663174 116-17 GL,AU,Umb,WC I Patra (1) 1 6/2/2017 2:28:03 PM (PDT) I Page 1 of 1 <br />