Orange County NC Website
DocuSign Envelope ID:897E46E3-FA01-48C0-AD59-05BF8E64A105 <br /> C � DATE(MM/DD/YYYY) <br /> 08/11/2017 <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 BELOW. <br /> THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE <br /> 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: <br /> AROUND THE CORNER INS PHONE FAX <br /> 1431 BROAD ST (AIC,No,Ext): I (AIC,No): <br /> E-MAIL <br /> ADDRESS: <br /> DURHAM NC 27705 <br /> 767HB INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA:TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA <br /> INSURED <br /> INSURER B: <br /> GONZALEZ PAINTERS AND INSURER C: <br /> CONTRACTORS INC <br /> 4301 BENNETT MEMORIAL RD INSURER D: <br /> DURHAM NC 27705 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 <br /> POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT <br /> WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES <br /> DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE <br /> BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGE TO RENTED <br /> COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence $ <br /> (CLAIMS-MADE n OCCUR MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS–COMP/OP AGG o <br /> POLICY'GA I PROJECT n LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) $ <br /> ANY AUTO AUTODULED BODILY INJURY(Per person) $ <br /> —ALL OWNED NON-OWNED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> PROPERTY DAMAGE <br /> HIRED AUTOS (Per accident) $ <br /> UMBRELLA LIAB _J OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEDI (RETENTION $ $ <br /> WORKERS COMPENSATION IWCSTATU- I IOTH- <br /> A AND EMPLOYERS'LIABILITY (6JUB-9F5658 1–2–1 7) 03-18-17 03-18–18 X TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? Y/N E.L.EACH ACCIDENT $ 1,000,000 <br /> (Mandatory in NH) C N/A 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 OPERATIONSILOCATIONSNEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREFO,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br /> POLICY PROVISIONS. <br /> ORANGE COUNTY <br /> AUTHORIZED REPRESENTATIVE <br /> HO BOX 8181 <br /> HILLSBOROUGH NC 27278 <br /> ©1988-2010 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />