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A'�9 0 CERTIFICATE OF LIABILITY INSURANCE °�T61262017 ' <br /> 06/26/2017 <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 pollcy(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 Hanover Excess&Surplus,Inc. E: TYSON INSURANCE SERVICES INC <br /> PO BOX 12450 PHONE 919-471-8222 FAx 919-471-6607 <br /> WILMINGTON,NC 28405 ArO,No.Eat (ArC,No]: <br /> Ana <br /> -ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC-It <br /> INSURERA: SCOTTSDALE INSURANCE COMPANY 41297 <br /> INSURED ORANGE TENNIS CLUB INSURERS: <br /> 3500 COTTON RUN RD INSURERC: <br /> EFLAND,NC 27243 <br /> INSURER D <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 /> I�TR TYPE OF INSURANCE SU R POLICY NUMBER MMIDDIYEYYV MMIDDIYYY LIMITS ism Im A X COMMERCIAL GENERAL LIABILITY 1,000,000 <br /> CAGH OCCLJRRENC,E $ <br /> A <br /> CLAIMS-MADE X OCCUR X CPS2549904 09/14/2016 09/14/2017 F IS - ooeuirencaL_ S 10l),D00 <br /> MED EXP(Any ono person) $5,000 <br /> _ PERSONAL 3 ADV INJURY $ 1,000,DOD <br /> GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE g 2,000,000 <br /> X POLICY❑PIERCOT F�LOC PRODUCTS•COWIOPAGG $2,000,000 <br /> OTHER S <br /> AUTOMOSILELIABILRY COMBINED SINGLE LIMIT <br /> Ea am dent $ <br /> ANYAUTO BODILY INJURY(Per persar) $ <br /> OWNED SCHEL'ULED <br /> AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTYDAMAGE $ <br /> AUTOS ONLY AUTOS ONLY rPsr ar�idgA <br /> UMBRELLALIAB Id OCCUR EACHOr.,CURRENCE S <br /> EXCESS LIAS CLAIMS-MADE I AGGREGATE. $ <br /> DED I I RETENTIONS $ <br /> WORKERS COMPENSATION - PER <br /> STATUTE EMPLOYERS'LIABILITY YIN STATUTE ER <br /> ANYPROPRI ETORPARTNERIEXECIff IVE E.L.EACH ACCIDENT $ <br /> OFFICFRIMEMBEREXCLUDED7 NIA <br /> (Mandatory In NH) E.L.OISEA.SE-EA.EMPLOYEE $ <br /> 11 yes,describe under <br /> DESCRIPTION OF OPERATIONS belaw I E.L.DISEASE-POLICY LIMIT $ <br /> Deductible:$ $ <br /> DESCRIPTION OF OPERATIONS ILOCATIONS/VEHICLES(ACORD 1111,Additional Remarks Schedule,may be attached If more apace is requiredl <br /> TENNIS CLUB/CLINIC <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY GOVERNMENT <br /> PO BOX 8181 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> HILLSBOROUGH,NC 27278 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENT—W. <br /> O 1988-2016 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />