Orange County NC Website
Browse       Search
DocuSign Envelope ID: B4D9BEED- F7D1- 45E2- BDC4- 3857401A2AB3 Iljblt 2 <br />ACCOR " CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM /DD /YYYY) <br />19/18/2017 <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 <br />HAUSER <br />5905 E. Galbraith Rd, Ste 9000 <br />Cincinnati OH 45236 <br />NAME: Valerie Kin <br />PH °NE 513- 745 -9200 FAX 513- 745 -9219 <br />A/C No <br />E -MAIL <br />ADDRESS: vkin g@thehauser rou 9 P• com <br />INSURERS AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Travelers Propert Casualty Co of Amer <br />25674 <br />8/30/2017 <br />INSURED <br />INSURER B :Travelers Property Casualty Co of Amer <br />25674 <br />TCPP, LLC <br />INSURERC:TRAVELERS IND CO OF CT <br />25682 <br />1 MacArthur PL Ste 400 <br />Santa Ana CA 92707 <br />INSURERD:NATIONAL UNION FIRE INSURANCE <br />51908 <br />INSURER E: GREENWICH INS CO <br />22322 <br />PREM SESOEa occurrDence <br />INSURER F: <br />MED EXP (Any one person) <br />COVERAGES CERTIFICATE NUMBER: 1800157567 REVISION NUMBER: <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM /DD /YYYY <br />POLICY EXP <br />MM /DD /YYYY <br />LIMITS <br />B <br />X <br />COMMERCIAL GENERAL LIABILITY <br />ZLP15T95597 <br />8/30/2017 <br />8/30/2018 <br />EACH OCCURRENCE <br />$1,000,000 <br />CLAIMS -MADE IX OCCUR <br />PREM SESOEa occurrDence <br />$300,000 <br />MED EXP (Any one person) <br />$10,000 <br />PERSONAL & ADV INJURY <br />$1,000,000 <br />GEN'L <br />AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$2,000,000 <br />POLICY ❑ PRO- <br />JECT ❑ LOC <br />PRODUCTS - COMP /OP AGG <br />$2,000,000 <br />$ <br />OTHER: <br />C <br />AUTOMOBILE <br />LIABILITY <br />BA8J19332A <br />8/30/2017 <br />8/30/2018 <br />COMBINED INGLE LIMIT <br />Ea accident S <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY X AUTOS ONLY <br />X <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />A <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />ZUP611084023 <br />8/30/2017 <br />8/30/2018 <br />EACH OCCURRENCE <br />$5,000,000 <br />AGGREGATE <br />$5,000,000 <br />EXCESS LIAB <br />CLAIMS -MADE <br />DED X RETENTION $0- <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />UB8J131574 <br />8/30/2017 <br />8/30/2018 <br />X PER OTH- <br />STATUTE ER <br />ANY PROPRIETOR/PARTNER /EXECUTIVE <br />E.L. EACH ACCIDENT <br />$1,000,000 <br />OFFICER/MEMBER EXCLUDED? ❑ <br />N/A <br />E.L. DISEASE - EA EMPLOYEE <br />$1,000,000 <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$1,000,000 <br />D <br />E <br />E &O /Cyber <br />Excess E &O /Cyber <br />01- 842 -02 -57 <br />MTE9035564 <br />8125/2017 <br />8/25/2017 <br />8125/2018 <br />8/25/2018 <br />$5,000,000 limit $100.000 Retention <br />$5,000,000 xs $5M $100,000 Retention <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2016/03) <br />©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 />For Informational Purposes Only <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />a- At. Wel�V <br />ACORD 25 (2016/03) <br />©1988 -2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />