Orange County NC Website
AC RLJ UA'I'111MMNDlYYI'VI <br />CERTIFICATE OF LIABILITY INSURANCE 6/4/2o1a <br />THIS CERTIFICATEIS 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 />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 this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />USI INS SVCS NATIONAL INC /PHS /NEW <br />272525 P: F:(888) 443 -6112 <br />PO BOX 29611 <br />CHARLOTTE NC 28229 <br />INSURED <br />VELASQUEZ DIGITAL MEDIA COMMUNICATIONS <br />LLC <br />PO BOX 62441 <br />DURHAM NC 27715 <br />COVERAGES CERTIFICATE NUMBER: <br />(AX.do.E.) (Z,NG) (888) 443 -6112 � <br />INSURER(S) AFFORDING COVERAGE <br />INSURER Ilnrl -lard 4aS1,11 Ly Iri1; 4r <br />INSURER B <br />INSURER C <br />INSURER D <br />INSURER E <br />INSURER F <br />NAICY <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. NOT WITHSTANDING ANY REOUIREMENI, ILRM 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 <br />TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LNSR <br />1)TE0ELVSIYIAN('1 <br />A004SIWR <br />INSERT ,N(MIJLR <br />POLRT /TT <br />MLI(I'L:CP <br />LLM /]S <br />COMMERCIALGENERALLIABILTY <br />EACH OCCURRENCE <br />:21,0001000 <br />CLAIMS -MADE OCCUR <br />DAMAGE TO RENTED nce) <br />PREMISES Ea occune <br />=3 O O , O O O <br />A <br />X <br />General Liab <br />211 SBM VIJ9I01 <br />Il' / /III /L0111 <br />11'1/()1/.:019 <br />MED EXP(my one person) <br />p10 r 000 <br />PERSONAL B ADV INJURY <br />)2, OOO(OOO <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />GENERALAGGREGATE <br />4r OOO, 000 <br />POLICY PRO LOC <br />ECT <br />PRODUCTS - COMP /OPAGO <br />�:4, OOO, OOO <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />(Ea aaldent) <br />,;2, OOO, OOO <br />BODILY INJURY (Per "man) <br />- <br />ANY AUTO <br />A <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />07 /01 /�ni <br />/ZUI <br />BODILY INJURY (Per accdenp; <br />PROPERTY DAMAGE <br />(Per acdount) <br />X. HIRED X NON -0WNEO <br />ALTOS ONLY AUTOS ONLY <br />UMBRELLA LIAB <br />EACH OCCURRENCE <br />EXCESS LIAB <br />HOCCUR <br />CLAIMS -MADE <br />AGGREGATE <br />DE <br />RETENDONT <br />NOAKfidb'(ONPP.N6.1T(O.V <br />ANDENPIOD:NYLI MFT <br />PER <br />STATUTE <br />OTH- <br />ER <br />ANY PROPRIETOR)PARTNERIEXECUTIVEY /N <br />E.L. EACH ACCIDENT <br />OFFICERIMEMBER EXCLUDED? <br />(MalMatary in NH) ❑ <br />NA <br />E.I. DISEASE- EAEMPLOYEE <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />DESCRIPTIONOFOPERATRHIIS /LOCATIONS / VEN/CPMRD 101, Additional Remaro; Schodula, may be attached B more spa" is required) <br />Those usual to the Insured's Operations. <br />CERTIFICATE HOLDER CANCELLATION <br />Orange County, <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br />Division Of Purchasing/Control /Control Services <br />�J <br />BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />Attn: Pam Jones <br />8181 <br />AUTHORIZED REPRESENTATIVE <br />PO BOX <br />HILLSBOROUGH, NC 27278 <br />©1988 -2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />