Orange County NC Website
DocuSign Envelope ID:9481C8DE-D232-4BFE-A7DF-F240644DFF63 <br /> ± CERTIFICATE OF LIABILITY INSURANCE 9/13/2017 DATE M; A <br /> D/ Y) <br /> ® <br /> A ± D® <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 /> CONT <br /> PRODUCER NAMEACT Vicki Dixon <br /> HAUSER <br /> PHONE FAX <br /> 5905 E. Galbraith Rd Suite 9000 E-/CA, EXt):513-745-9200 (A/C,No):513-745-9129 <br /> Cincinnati OH 45236 ADDRESS:Vdixon©p thehausergroup.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Ohio Security Insurance Co 24082 <br /> INSURED MANAG-2 INSURER B:American Fire&Casualty Co 24066 <br /> Management Partners, Inc. INSURER C:The Ohio Casualty Ins. Co. 24074 <br /> 1730 Madison Road INSURER D:Conti nental Casualty Co. 35289 <br /> Cincinnati OH 45206 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:967500416 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 <br /> INSR SUBR <br /> WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> (MM/DD/YYYY) (MM/DD/YYYY) <br /> A GENERAL LIABILITY Y Y BKS57826057 3/1/2017 3/1/2018 EACH OCCURRENCE $1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PR S( RENTED <br /> PREMISES(Ea occurrence) $1,000,000 <br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $15,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 <br /> POLICY PRO LOC OHIO STOP GAP $1,000,000 <br /> JECT <br /> B AUTOMOBILE LIABILITY Y Y BAA57826057 3/1/2017 3/1/2018 COMBINED SINGLE LIMIT <br /> (Ea accident) $1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE <br /> X HIRED AUTOS X AUTOS (Per accident) $ <br /> $ <br /> C X UMBRELLA LIAB X OCCUR Y Y US057826057 3/1/2017 3/1/2018 EACH OCCURRENCE $3,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $3,000,000 <br /> DED X RETENTION$0 $ <br /> A WORKERS COMPENSATION y XWS57826057 3/1/2017 3/1/2018 X WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE 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 /> D Mgmt.Prof.Liability 596801719 6/20/2017 3/1/2018 Mgment Liab Profess. $1,000,000 <br /> Deductible Deductible $10,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION 30 days except 10 days for non pay <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County 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 weii.Azi_12,4e <br /> I <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />