Orange County NC Website
Browse       Search
DocuSign Envelope ID: F06C131E9- 0497 -47BD- 9305- F943B019EAD3 <br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE <br />DATE(MM /DD/YYYY) <br />7/10/2018 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Sports & Fitness Insurance <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />212 Key Drive <br />Madison, MS 39110 <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE X OCCUR <br />❑ <br />X Professional <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURED <br />Alicia Arence Reid, <br />INSURER A: General Insurance Company of America <br />1,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea cccurence <br />1,000,000 <br />3508 Borland Road <br />INSURER B: <br />PERSONAL & ADV INJURY <br />1,000,000 <br />INSURER C: <br />2,000,000 <br />INSURER D: <br />PRODUCTS - COMP /OP AGG <br />Efland, NC 27243 <br />INSURER E: <br />AUTOMOBILE <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUC <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />LTR <br />ADD' <br />NSRD <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />POLICY EFFECTIVE <br />DATE MM /DD/YY <br />POLICY EXPIRATION <br />DATE MM /DD/YY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE X OCCUR <br />❑ <br />X Professional <br />LPF- 9653051A <br />7/17/2018 <br />7/17/2019 <br />EACH OCCURRENCE <br />1,000,000 <br />DAMAGE TO RENTED <br />PREMISES Ea cccurence <br />1,000,000 <br />MED EXP (Any one person) <br />10 000 <br />PERSONAL & ADV INJURY <br />1,000,000 <br />GENERAL AGGREGATE <br />2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER <br />RO - <br />POLICY JECT LOU P <br />PRODUCTS - COMP /OP AGG <br />2,000,000 <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />BODILY INJURY <br />(Per person) <br />BODILY INJURY <br />(Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />GARAGE <br />LIABILITY <br />ANY AUTO <br />AUTO ONLY - EA ACCIDENT <br />OTHER THAN EA ACC <br />AUTO ONLY: AGO <br />EXCESS /UMBRELLA LIABILITY <br />OCCUR ❑ CLAIMS MADE <br />DEDUCTIBLE <br />RETENTION <br />EACH OCCURRENCE <br />AGGREGATE <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />ANY PROPRIETOR /PARTNER /EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? <br />If yes, describe under <br />SPECIAL PROVISIONS below <br />we ST MI o ER <br />TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOY <br />',E <br />E.L. DISEASE - POLICY LI14IT <br />OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />GroupX Instruct <br />CERTIFICATE HOLDER CANCELLATION <br />Alicia Arence Reid <br />3508 Borland Road <br />Efland, NC 27243 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2001/08) © ACORD CORPORATION 1988 <br />