2017-567-E DEAPR - R.S. Jones & Associates, Inc. for land survey services for recordable plat for the Fickle Creek farmland conservation easement

Browse Search

DocuSign Envelope ID:98B5B763-686F-456E-B7B9-7AB597653B0C A� D! LA CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DYYYY) 10/11/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT CARL A.WALKER. CARL A.WALKER INSURANCE AGENCY INC PHONE Est): 919-563-0051 I FAX No): 919-563-0053 PO BOX 553 A-DRESS: CARL @CARLWALKERINSURANCE.COM INSURER(S)AFFORDING COVERAGE NAIC t MEBANE NC 27302 INSURER A: ERIE INSURANCE EXCHANGE 26271 INSURED INSURER B: WESTCHESTER FIRE INSURANCE COMPANY 21121 R S JONES&ASSOCIATES INC INSURER C: 201 W CLAY ST INSURER D: MEBANE,NC 27302 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUMR . LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDFYYYY POLICY EXP `j ) (MM1DDlYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 — UAMAGE IURENILU I1C44 COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 2,000,000 i. CLAIMS-MADE I�� OCCUR MED EXP(Any one person) $ 5,000 A � Q421690212 06/16/2017 06/16!2018 PERSONAL&ADV INJURY_ $ 2,000,000 it GENERAL AGGREGATE $ 4,000,000 GEN'LAGGRE�GATE LIMIT APPLIES PER: PRODUCTS-COMP/OP $ 4,000,000 I POLICY /4 JPR O 7J I LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMI r $ 1,000,000 - (Ea accident) I ANY AUTO BODILY INJURY(Per person) $ I �� A �! ALL O NED V= SCHEDULED Q061630431 06/16/2017 06/16/2018 BODILY INJURY(Per accident) $ Ill HIRED AUTOS • NON-OWNED PROPERTY DAMAGE AUTOS (Per accident) $ , kJ' UMBRELLA LIAB �_'I OCCUR J $ I+ EACH OCCURRENCE $ 3,000,000 A 1.1 EXCESS LIAB •I CLAIMS-MADE Q301670212 06/16/2017 06/16/2018 AGGREGATE _ $ 3,000,000 DED RETENTION$ $ — WORKERS COMPENSATION I WC STATU- FN.,/OTH-' AND EMPLOYERS'LIABILITY YIN u TORY LIMITS �V��1 ER A OFFICER/MEMBER EAXCLU DE © N 1 A Q902100491 06/21/2017 06!2112018 E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ 500,000 PROFESSIONAL LIABILITY Limit:$1,000,000 aggregate B ' G27934092 002 12/16/2016 12/16/2017 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ORANGE COUNTY NORTH CAROLINA AUTHOR 0 REPRESENTATIVE 202 S CAMERON STREET ) rte, HILLSBOROUGH NC 27278 4...„ .-c<.- , i c-k; ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD