Orange County NC Website
DocuSign Envelope ID: 6818677A -D518- 4750- B391- F6169FB2A4C4 <br />AHELP -1 <br />rte- DATE (AtlId+DDrYYYY) <br />CERTIFICATE �F LIABILITY INSURANCE 07/10/2018 <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 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 <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER 773- 754-0849 CONTACT <br />S. Wolf and Associates, Inc, NAME <br />2338 W. Morse [AfC, Rio, Extl: 773-754 -0849 <br />Chicago, IL 60645 E -MAIL <br />Polly Kosyla88E - - - - -- --�_ <br />INSORER(S) AFFORDING COVERAGE NA1C # <br />............ ____.__ IHSURERA:WesCo Insurance Company <br />INSURED A Helping Hand NC _ INSURER B -_ ......... <br />Jon niferAshley <br />1502 W NC Hwy 54 -#405 LX§42ERC: _ <br />Durham, NC 27707 1 -11... n. <br />INSURER F: <br />rnVFRAr.FC f'COTICIr ATC KIIIl1Aa CO• QCVIC VIN LI II ILA 12=12- <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 />- <br />TYPE OF INSURANCE off- UDR ppDCY NUMBER POLICY EFF POLICY EXP LIMITS - - - <br />iLT R - <br />PO box 8181 <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE � OCCUR <br />Hillsborough, NC 27218 <br />I <br />AUT"CR11ED REPRESENTATWE <br />" 6116144-- <br />�'f�'� 61 <br />EACH OCCURRENCE <br />DAMAGE TO RENTED <br />MED EXP (Any one person) <br />S <br />PERSONAL 8 ADV INJURY <br />i— <br />GEN'L <br />GENERAL AGGREGATE <br />,- ._- .-- ._..._— __..._ <br />S <br />AGGREGATE LIMIT APPLIES PER: <br />POLICY L _J J FI LOC <br />PRODUCTS - COMP/OPAGG <br />- -. -- <br />OTHER' <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY JPer rson <br />BODILY INJURY Per accident S __. <br />AUTOS ONLY AUTO V6' L6 <br />PROPERTY _ r_anc t MADE c <br />c <br />UMBRELLA LIAB OCCUR <br />EACH OCCURRENCE S <br />EXCESS LIAR CLAIMS -MADE <br />AGGREGATE. S <br />DED I i RETENTION $ <br />A <br />WORKERS COMPENSATION <br />X PER OTH- <br />STATUTE rR <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETORIPARTNERfEXECUTIVE YID <br />FICE Mgg EXCLUDED? L� <br />landaM laryn NHy �� <br />R yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N 1A <br />WWC3356988 0713412018 <br />07130/2019 <br />E.L. EACH ACCIDENT <br />1,000,000 <br />$ <br />E.L. DISEASE - EA EMPLOYE <br />1,000,000 <br />--' --"" <br />E.L. DISEASE - POLICY LIMIT <br />... . <br />1'4QQ' ©QQ <br />I <br />I <br />DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, AddI ional Remarks Schedule, may be attached if more space is required) <br />rF:PTIFIr ATF 1-Ir11 nFR f AA1!'CI I ATInm <br />ACORD 25 (2016103) ©1988 -2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and Logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />Orange County Government <br />THE <br />ACCORDANCE WFTHTHE POUCYRPROVISIONSE WILL BE DELIVERED IN <br />200 South Cameron Street <br />PO box 8181 <br />Hillsborough, NC 27218 <br />I <br />AUT"CR11ED REPRESENTATWE <br />" 6116144-- <br />�'f�'� 61 <br />ACORD 25 (2016103) ©1988 -2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and Logo are registered marks of ACORD <br />