Orange County NC Website
Browse       Search
DocuSign Envelope ID: 5D25D6E0-716B-4244-AEA3-02E6A45FD852 <br /> A a CERTIFICATE OF LIABILITY INSURANCE 12T/'31/201'6 <br /> THIS CERTIFICATEIS 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 this <br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: <br /> BB&T INSURANCE SER`JICES INC/PHS ,a°No,Ext): (866) 467-8730 (AC.00I: (888) 443-6112 <br /> 272545 P: (866) 467-8730 F: (888) 443-6112 AoR'ESS: <br /> PO BOX 29611 INSURER(S)AFFORDING COVERAGE NAICA <br /> CHARLOTTE NC 28229 INSURER A: Sentinel Ins Co LTD <br /> INSURED <br /> INSURER B: <br /> INSURER C: <br /> COMMUNITY EMPOWERMENT FUND INSURER D. <br /> 208 N COLUMBIA ST STE 100 INSURER E. <br /> CHAPEL HILL NC 27514 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 <br /> TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ISR TYPE OF INSI724NCE I ADDL SUBR POLICY-,NUMBER I POLICY EFF POLICY EAP LIMITS <br /> IIVSR NTT OfM14/DIWYYip IMM/I>D/r1TY) <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 12, 000, 000 <br /> CI-AIMS-MADE X OCCUR DAMAGE TO RENTED <br /> PREMISES(Ea occurrence) $1-r 000, 000 <br /> A X General Liab 22 SBN EN9653 01/26/2017 01/26/2013 MEDEXP(Anyoneperson) $10, 000 <br /> PERSONAL&ADV INJURY ,2, 000, 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE ,4, 000, 000 <br /> POLICY I JE G- <br /> OTHER: I n LOC PRODUCTS-COMP/OP AGG $4, 000, 000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT r,2 0 0 0 0 0 0 <br /> I (Ea accident) r r <br /> ANY AUTO BODILY INJURY.(Per pe,sen) <br /> OWNED SCHEDULED <br /> AUTOS ONLY IAUTOS 22 SBN_I EN9653 01/26/2017 01/26/2013 BODILY INJURY(Per accident)$ <br /> X HIRED X NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DE RETENTION$ <br /> WORKERS COMPENSATION PER OTH- <br /> 4V)&LILOVERS'LL4AUJTY STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEYIN E.L.EACH ACCIDENT 's <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) I i wA E.L.DISEASE-EA EMPLOYEE <br /> If yes.describe under E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHIG(IRSORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Those usual to the insured's Operations. <br /> I <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> Orange County DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 AUTHORIZED REPRESENTATIVE <br /> 200 S CAMERON ST <br /> HILLSBOROUGH, NC 27278 <br /> ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />