Orange County NC Website
DocuSign Envelope ID: 8781 E5D4-347A-4B91-BD06-5EE2250879BF <br /> AC©R©® CERTIFICATE OF LIABILITY INSURANCE DATE(Mr.1,GD,YYYY) <br /> 08/10/2017 <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 CONTACT <br /> [NAME: Anna Herron <br /> The Insurance Pros. Inc. <br /> PHONE iE No Etl) (919)294-6613 FAX c,Nn)( 866)294-9470 <br /> 1210 Cole Mill Road AE-MAIL info@insuranceprosonline.com <br /> Suite 101 INSURER(S)AF FORDING COVERAGE NAIC <br /> Durham NC 27705 INSURER A: Erie Ins Exch 26271 <br /> INSURED <br /> INSURER B <br /> Wayne Thompson DBA Heritage Restoration INSURER C <br /> PO Box 814 INSURER D: Erie Ins Exch 26271 <br /> INSURER E <br /> Hillsborough NC 27278 IJSURERF: <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 SUBR POLICY EFF POLICY EXP LIMITS <br /> INSD WVD POLICY NUMBER (MMSDD,'YYYY) (k1M,DD,YYYY) <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMI SES(Ea occurrence) $ 1000000 <br /> MED EXP(Any one person) $ 5000 <br /> A N N Q25-2721076 01/27/2017 01/27/2018 PERSONAL&ADV INJURY $ 1000000 <br /> GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 <br /> X POLICY PROT LOC PRODUCTS-COMPIOPAGG $ 2000000 <br /> JEC <br /> OTHER $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <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 accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION X STATUTE OTH <br /> AND EMPLOYERS'LIABILITY Y;N <br /> D OFFICER/MEMBER EMBER+EXGLUDED�XECUTIVE N LA N Q86-1700646 02/17/2017 02/17/2018 EL EACH ACCIDENT $ 100000 <br /> (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 100000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 <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 /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO BOX 8181 <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> Fax: Email: ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />