Orange County NC Website
DocuSign Envelope ID: 36B148C8- F8C5- 47E8- 89C8- OD5A5FD8199D <br />NORTH CAROLINA FARM BUREAU MUTUAL INSURANCE COMPANY, INC. <br />CERTIFICATE OF LIABILITY INSURANCE <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 pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject <br />to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to <br />the certificate holder in lieu of such endorsement(s). <br />INSURED MULBERRY BUILDING CO LLC <br />CERTIFICATE DEPARTMENT OF ENVIRONMENT, <br />NAME AND 9501 NC HWY 85 N <br />HOLDER AGRICULTURE, PARKS & RECREATION <br />ADDRESS CEDAR GROVE NC 27231 <br />PO BOX 8181 <br />HILLSBOROUGH NC 27278 <br />GL 0519139 <br />M CARR @ORANG ECOUNTYNC.GOV <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 />M. <br />TYPEOFINSURANCE <br />A LSUBR <br />IN= <br />uuvn <br />POUCYNUMBER <br />POiJCYEFP <br />�IC P <br />LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />GL 0519139 <br />$11/201.7 <br />811/2018 <br />GENERALAGGIREGATE <br />$2,000,000 <br />-OCCURRENCE <br />PRODUCTS - COMP /OPS <br />AGGREGATE <br />(y(] <br />$1,000,000 <br />GEN °L AGGREGATE APPLIES PER POLICY <br />PERSONAL& AGV INJURY <br />1.000,000 <br />EACH OCCURRENCE <br />$1,000,000 <br />$100,000 <br />PR MRSESWaQM <br />$5,00() <br />MELD EXP (Any one person) <br />BUSENESSOWNER3 <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />AUTOMOBILE LIABILITY <br />BAP 2173110 <br />2/1/2018 <br />81112018 <br />COMBINED SINGLE UMrr <br />(Each accident) <br />$1,000,000 <br />SCHEDULED AUTOS <br />BODILY INJURY (P ®r person) <br />$ <br />HIRED AUTOS <br />BODILY INJURY (Per w want) <br />$ <br />NON - OWNED AUTOS <br />PROPERTYDAMAGE <br />$ <br />Par eccidenl <br />❑ <br />GARAGE LIABILITY <br />(Other) <br />El <br />EXCESS LIABILITY— <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />OCCURRENCE <br />® <br />WORKERS COMPENSATION <br />NIA <br />WC STATUTORY LM8r5 <br />E.L. EACH ACCIOENT <br />$100,000 <br />AND EMPLOYERS' LIABILITY <br />WC 0251647 <br />811!2017 <br />81112018 <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />POLICY APPLIES TO THE WORKERS <br />COMPENSATION LAW IN THE STATE OF NO <br />E.C. DISEASE- POLICY LIMrr <br />$500' 000 <br />OTHER: <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES: <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED AUTHORIZED REPRESENTA <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DATE 3120/2018 <br />COI 0910 <br />