Orange County NC Website
DocuSign Envelope ID:321 C52EE-8B79-48AB-9A10-D537FC55F7BB <br /> ACORL)® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 411.0.,, 10/16/2017 <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 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 <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER NAMEACT Pamela Paul <br /> Watson Insurance PHONE 704-865-8584 FAX 704-866-9866 <br /> 245 East Second Avenue (A/C,No,Ext): (NC,No): <br /> Gastonia NC 28053 ADDRESS:ppaul @watsoninsurance.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Cincinnati Insurance Company 10677 <br /> INSURED INSURER B:Travelers Casualty&Surety Company of 19038 <br /> Stewart-Cooper-Newell Architects, P. A. INSURER c:Accident Fund National Insurance Company 12305 <br /> 719 East Second Ave <br /> Gastonia NC 28054 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:2036261375 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 SUBR POLICY EFF POLICY EXP W /Y LIMITS <br /> LTR INSD VD POLICY NUMBER (MM/DD YYY) (MM/DD/YYYY) <br /> A x COMMERCIAL GENERAL LIABILITY Y EPP0184359 7/7/2017 7/7/2018 EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE X OCCUR <br /> DAMAGE TO RENTED <br /> PREMISES( <br /> SES(Ea occurrence) $500,000 <br /> MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $2,000,000 <br /> X POLICY X PRO-JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY Y EBA0184359 7/7/2017 7/7/2018 COMBINED SINGLE LIMIT $ <br /> (Ea accident) 500,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> X OWNED X SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> X AUTOS ONLY X AUTOS ONLY (Per accident) $ <br /> $ <br /> A UMBRELLA LIAB X OCCUR EPP0184359 7/7/2017 7/7/2018 EACH OCCURRENCE $1,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $1,000,000 <br /> DED X RETENTION$0 $ <br /> C WORKERS COMPENSATION WCV6145835 7/7/2017 7/7/2018 X PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE 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 /> B Professional Liability 105598431 4/17/2017 4/17/2018 Occurence $1,000,000 <br /> Aggregate $2,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 131 West Margaret Lane ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> . .. <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />