Orange County NC Website
DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE <br />THISCERTIFICATEISISSUEDASAMATTEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTIFICATEHOLDER.THIS <br />CERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIES <br />BELOW.THISCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT:IfthecertificateholderisanADDITIONALINSURED,thepolicy(ies)mustbeendorsed.IfSUBROGATIONISWAIVED,subjectto <br />thetermsandconditionsofthepolicy,certainpoliciesmayrequireanendorsement.Astatementonthiscertificatedoesnotconferrightstothe <br />certificate holder in lieu of such endorsement(s). <br />CONTACTPRODUCERNAME: <br />FAXPHONE <br />(A/C, No):(A/C, No, Ext): <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGENAIC # <br />INSURER A : <br />INSURED INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: <br />THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIOD <br />INDICATED.NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS <br />CERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ADDLSUBRINSR POLICY EFFPOLICY EXPTYPE OF INSURANCE LIMITSPOLICY NUMBERLTR (MM/DD/YYYY)(MM/DD/YYYY)INSRWVD <br />GENERAL LIABILITY EACH OCCURRENCE$ <br />DAMAGE TO RENTED <br />COMMERCIAL GENERAL LIABILITY $PREMISES (Ea occurrence) <br />CLAIMS-MADEOCCUR MED EXP (Any one person)$ <br />PERSONAL & ADV INJURY$ <br />GENERAL AGGREGATE$ <br />GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ <br />PRO-$POLICYLOCJECT <br />COMBINED SINGLE LIMITAUTOMOBILE LIABILITY (Ea accident)$ <br />BODILY INJURY (Per person)$ANY AUTO <br />ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$AUTOSAUTOS <br />NON-OWNED PROPERTY DAMAGE $HIRED AUTOS (PER ACCIDENT)AUTOS <br />$ <br />UMBRELLA LIAB EACH OCCURRENCE$OCCUR <br />EXCESS LIAB CLAIMS-MADE AGGREGATE$ <br />$DEDRETENTION$ <br />WC STATU-OTH-WORKERS COMPENSATION <br />TORY LIMITSERAND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$N / AOFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH)E.L. DISEASE - EA EMPLOYEE$ <br />If yes, describe under <br />E.L. DISEASE - POLICY LIMIT$DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />CERTIFICATE HOLDERCANCELLATION <br />SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORE <br />THEEXPIRATIONDATETHEREOF,NOTICEWILLBEDELIVEREDIN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORDACORD 25 (2010/05) <br />Michelle R. Long <br />YESTE-1OP ID: ML <br />08/09/2018 <br />Insurance People <br />P. O. Box 3006 <br />Durham, NC 27715-3006 <br />Michelle R. Long <br />Cincinnati Ins. Co.10677 <br />AmTrust North AmericaYesterYears Brewery LLC <br />300 E. Main St., Suite C <br />Carrboro, NC 27510 <br />1,000,000 <br />AXX ETD 032850305/16/201805/16/2019 100,000 <br />X 5,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />Liquor Li1,000,000 <br />1,000,000 <br />A ETD 032850305/16/201805/16/2019 <br />XX <br />XX 1,000,000 <br />A ETD 032850305/16/201805/16/2019 1,000,000 <br />X0 <br />X <br />B TWC370557203/29/201803/29/2019 500,000 <br />500,000 <br />500,000 <br />Main Street Properties as landlord is an Additional Insured with regard to <br />General Liability per written contract. <br />MAINSTP <br />Main Street Properties <br />P. O. Box 2152 <br />Chapel Hill, NC 27515 <br />DocuSign Envelope ID: 5B6B65BF-2247-4452-85C6-7A7F968004C2