Orange County NC Website
DocuSign Envelope ID: 8D759C14- 37D5- 44D8- A8F3- B194B7034410 <br />ACC? " CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM /DDNYYY) <br />1/29/2018 <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 />PRODUCER <br />CONTACT Doug arber <br />NAME: g <br />V NNO Ext: (704) 799 -1600 A/C No: (704)799 -2955 <br />Insurance Management Consultants, Inc. <br />E- MAILss:cert @imcipls.com <br />ADDRE <br />P.O. Box 2490 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURERA:Continental Casualty Company <br />20443 <br />Davidson NC 28036 <br />INSURED <br />INSURER B <br />INSURER C : <br />Hart & Hickman, PC <br />INSURER D: <br />2923 South Tryon Street <br />INSURER E: <br />Suite 100 <br />INSURER F: <br />CLAIMS -MADE � OCCUR <br />Charlotte NC 28203 <br />COVERAGES CERTIFICATE NUMBER:3 /1/17 Renewal 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 <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />MM /DD/YYYY <br />POLICY EXP <br />MM /DDNYYY <br />LIMITS <br />Jeff Todd /DGF%'� <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ <br />DAMAGE TO RENTED <br />CLAIMS -MADE � OCCUR <br />PREMISES Ea occurrence <br />$ <br />MED EXP (Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ <br />POLICY ❑ PRO ❑ LOC <br />JECT <br />PRODUCTS - COMP /OP AGG <br />$ <br />$ <br />OTHER: <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />UMBRELLA LIAB <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />HCLAIMS-MADE <br />AGGREGATE <br />$ <br />EXCESS LIAB <br />DED RETENTION $ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />PER OTH- <br />STATUTE I I ER <br />ANY PROPRIETOR /PARTNER /EXECUTIVE <br />E.L. EACH ACCIDENT <br />$ <br />OFFICER /MEMBER EXCLUDED? ❑ <br />N / A <br />E.L. DISEASE - EA EMPLOYE <br />$ <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />A <br />Professional Liability <br />ECH288346016 <br />3/1/2017 <br />3/1/2018 <br />Each Claim $3,000,000 <br />Aggregate $5,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />webadmin@orangecountync.go <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Orange County <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />P.O. Box 8181 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />Hillsborough, NC 27278 <br />AUTHORIZED REPRESENTATIVE <br />Jeff Todd /DGF%'� <br />ACORD 25 (2014/01) <br />INS025 (201401) <br />© 1988 -2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />