2018-105-E Health - Rochette and Associates training

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DocuSign INSURANCE DATE (MM/DD/YYYY) 9/26/2017 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER INSURANCE NOODLE LLC /PHS 551718 P:(866) 467 -8730 F:(888) 443 -6112 PO BOX 29611 CHARLOTTE NC 28229 CONTACT NAME: ANC "IV,Ext): (866) 467 -8730 FAX (888) 443 -6112 ADDRIESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: Hartford Casualty Ins Co 29424 INSURED ROCCHETTI AND ASSOCIATES INC 10204 HALLBERG LN RALEIGH NC 27614 INSURER B COMMERCIAL GENERAL LIABILITY INSURER C: INSURER D: INSURER E: EACH OCCURRENCE INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IASR LTR TYPE OF INSURA NCE ADDL IN SR SUBR WVD POLICYNUMBER POLICY EFF (MMIDDIYYYY) POLICYEXP MMDD YYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1, 000, 0 0 0 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) s300,000 X MED EXP (Any one person) $10, 000 A General Liab 83 SBM TL0404 04/19/2017 04/19/2018 PERSONAL & ADV INJURY $1, 000, 0 0 0 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s2, 0 0 0 , 000 POLICY JECT PRO 7 LOC PRODUCTS - COMP /OP AGG $2, 0 0 0 , 000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORRL'RSCOMPE,h'.SATION A,h'D EMPLOYERS'LLABILITY PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR /PARTNER /EXECUTIVE Y/N OFFICER /MEMBER EXCLUDED? (Mandatory in NH) ❑ NIA E.L. DISEASE- EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS /LOCATIONS/ VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ORANGE COUNTY HEALTH DEPARTMENT 300 W TRYON STS HILLSBOROUGH, NC 27278 ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD