Orange County NC Website
DocuSign Envelope ID:2A218EB2-15F4-4CE7-96F9-659CCOBBAD33 <br /> r 0 DATE(MM/DDIYYYY) <br /> ACC,RD CERTIFICATE OF LIABILITY INSURANCE <br /> -,.. 08/28/2017 <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 /> — <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 NAME CT Matt Phillips <br /> State Farm Matt Phillips PJ4NHE^ EM), 919-929-9552 I FAX,Nob 919-945-0024 <br /> E.MAIL p q -----. <br /> 73 S Elliott Road ADDRESS: maiLphipi s. ug2 @statefarm.com <br /> C),, <br /> • <br /> INSURER(S)AFFORDING COVERAGE NAIL 1/ <br /> Chapel Hill NC 27514 INSURER A: State Farm Fire and Casualty Company 25143 <br /> ■ INSURED INSURER B: <br /> VIP Signs Express,Inc. INSURER C: <br /> 99 S Elliott Road INSURER D; <br /> Ste 5 INSURER E: <br /> i -•--- <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 TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUER POLICY E POLICY EXP LIMITS <br /> LTR INSD 0. POLICY NUMBER ,JMM/OD/Y LIMMIDDIYYYYI <br /> XCOMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TORENTED 300,000 <br /> CLAIMS-MADE �1 OCCUR PREMISE$(Ea occurrancet S <br /> — MED EXP(Any one person) $ 5,000 <br /> 93-CN-H321-2 07/16/2017 07/16/2018 PERSONAL aADVINJURY <br /> $ 1,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> IPOLICY I I jE LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER' __.... $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> IEssccidonII <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS • <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY _ AUTOS ONLY , Per eeldonll <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS UAB CLAIMS-MARE AGGREGATE S <br /> DED I I RETENTION 5 ( $ <br /> WORKERS COMPENSATION 1 PER -I I ORH. I' <br /> AND EMPLOYERS'LIABILITY <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICERIMEMBEREXCLUDED? I Y I NIA 93-C6-F869-4 08/28/2017 07/28/2018 1,000,000 <br /> (Mandatory In NH) E,L.DISEASE-EA EMPLOYEE $ <br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S 2,000,000 <br /> • <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached N more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> NNP-Briar Chapel,LLC ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1342 Briar Chapel Parkway <br /> AUTHORIZED REPR ENTATIV <br /> Chapel Hill NC 27516 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> 1001486 132649,12 03-16-2016 <br />