Orange County NC Website
Browse       Search
DocuSign Envelope ID: FE562994- 247A- 4BEF- A63A- 074755E44AEB <br />AC " <br />16-� <br />AGENCY CUSTOMER ID: 35SMEINC <br />LOC #: <br />ADDITIONAL REMARKS SCHEDULE <br />Page 1 of 1 <br />AGENCY <br />BS &T Insurance Services, Inc. <br />NAMED INSURED <br />S &ME Inc. <br />3201 Spring Forest Rd, <br />Raleigh, NC 27616 <br />POLICY NUMBER <br />CARRkER 77C <br />COKE <br />EFFECTIVE DATE: <br />ADDITIONAL REMARKS <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br />be provided with notice of cancellation of the policy. <br />Project: Orange Co - Hiflsbarough PRLF (Project No. 4305 -17 -061) <br />Orange County, North Carolina Is included as Additional Insured with respect to General Liability and Automobile Liability Coverage. Umbrella Liability is written <br />on a Fcllow -Farm basis over the underlying General Liability, Automobile Liability and Employers Liability policies. Professional Liability includes Contractors <br />Pollution Legal Liability and is written on a claims made basis. Certificate holder is additional insured for Contractors Pollution Legal Liablilty if required by written <br />agreement, but solely to the extent that the INSUREDS liability arises out of Contracting Services rendered by or on behalf of the NAMED INSURED. <br />ACORD 101 (2008101) O 2008 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />