Orange County NC Website
CERTIFICATE OF LIABILITY INSURANCE <br />DATE 04 /17/D/YYYY) <br />04/17/2018 <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 BELOW. THIS <br />CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR <br />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. If <br />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 endorsements . <br />PRODUCER <br />FEDERATED MUTUAL INSURANCE COMPANY <br />HOME OFFICE: P.O. BOX 328 <br />CONTACT <br />NAME: CLIENT CONTACT CENTER <br />PHOE <br />A CNNo Ext : 888 - 333 -4949 (A C No): 507 - 446 -4664 <br />E -MAIL <br />ADDRESS: CLIENTCONTACTCENTER FEDINS.COM <br />OWATONNA, MN 55060 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />02/11/2019 <br />INSURER A: FEDERATED MUTUAL INSURANCE COMPANY <br />13935 <br />INSURED 348 -705 -5 <br />INSURER B: <br />TRADEMASTERS SERVICES INCORPORATED <br />INSURER C: <br />GEN'L <br />NOTHER: <br />5012 NEAL RD <br />INSURER D: <br />$1,000,000 <br />DURHAM, NC 27705 -2362 <br />INSURER E: <br />$2,000,000 <br />PRODUCTS - COMPIOP AGG <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER: 34 REVISION NUMBER: 2 <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, EXCLUSIONS <br />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 />INSR <br />SUER <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDDIYYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F OCCUR <br />Y <br />N <br />9337203 <br />02/11/2018 <br />02/11/2019 <br />EACH OCCURRENCE <br />$1,000,000 <br />DA AGE <br />PREMISES Ea or uE rrence <br />$100,000 <br />MED EXP (Any one person) <br />EXCLUDED <br />GEN'L <br />NOTHER: <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY ❑ SECT ❑ LOC <br />GENERAL AGGREGATE <br />$2,000,000 <br />PRODUCTS - COMPIOP AGG <br />$2,000,000 <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />OWNED AUTOS ONLY SCHEDULED <br />AUTOS <br />HIRED AUTOS ONLY NON -OWNED <br />AUTOS ONLY <br />Y <br />N <br />9337203 <br />02/11/2018 <br />02/11/2019 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$1,000,000 <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />APer accident <br />A <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />N <br />N <br />9337204 <br />02/11/2018 <br />02/11/2019 <br />EACH OCCURRENCE <br />$5,000,000 <br />AGGREGATE <br />$5,000,000 <br />DED I I RETENTION <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y/N <br />ANY PROPRIETORIPARTNERIEXECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />N <br />9337205 <br />02/11/2018 <br />02/11/2019 <br />X <br />PER STATUTE <br />OTH- <br />ER <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />E.L DISEASE - POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />SEE ATTACHED PAGE <br />CERTIFICATE HOLDER CANCELLATION <br />348 -705 -5 <br />342 <br />ORANGE COUNTY <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES <br />BE CANCELLED BEFORE <br />PO BOX 8181 <br />THE EXPIRATION DATE THEREOF, NOTICE <br />WILL BE DELIVERED IN <br />HILLSBOROUGH, NC 27278 -8181 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />�+ <br />G A <br />� V , �n� <br />© 1988 -2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />