Orange County NC Website
DocuSign Envelope ID: AEDEF235- 8770- 4AA4- 868D- B7F9A7872965 <br />DATE(MMIDDrYYYY) <br />CERTIFICATE OF LIABILITY INSURANCE 08n6f2018 <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 CONTACT <br />NAME Charlie Dickerson <br />A C <br />The Insurance Pros. Inc. u (919)294-6613 7 <br />PHONE Ne : 866j294°9470 <br />1210 Cole Mill Road ADDRESS: info oinsurance rosonline.com <br />Suite 101 INSUREWSI AFFORDING COVERAGE NAIL M <br />Durham NC 27705 INSURER A: Erie Ins Exch 26271 <br />INSURED — — — INSURER a : Erie Ins Exch 26271 <br />Tarheel Glass, Inc. 114SURER C: Erie Ins Exch —Ta 2 6271 <br />151 Eloone Square Street INSURER D: <br />Hlllsboraugh NC 27278 f INSURER F: <br />COVFRACIFS C FRTIFIC:ATF NUMRFR RFVISir)N NIIMRFR' <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 />TYPE Or INSURANCE <br />ADD( <br />SUBR <br />POLICY NiIk4BFR <br />POLICY EFF <br />J! AI <br />POLICY E7[P <br />fr <br />— — LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />_. CLAIMS MAUE l!.�.J OCCUR <br />N <br />N <br />Q30- 2221018 <br />06/22/2018 <br />05122/2019 <br />EACH OCCURRENCE <br />$ 1000000 <br />PREkAISES Eaoccllrrence <br />$ 1000000 <br />$ 5000 '. <br />M E D EXP (Air yrum parson) <br />PERSONAL&ADVINJURY <br />$ 10000DO <br />GEN'L AGGREGATE LIMITAPPUESPER: <br />POLICY ❑ PRJECOT I _J - I-'^t <br />LOO <br />OTI IER: <br />GENERA - AGGREGATE <br />$ 2000000 <br />PRO DUCTS - COMPFOPAGG <br />$ 2000000 <br />$ <br />B <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />OVMEO - SCHEDULED <br />AUTOS ONLY AUTOS <br />HIRED NON-OWNED <br />AUTOS ONLY AUTOS ONLY <br />N <br />N <br />'QOS- 2130939 <br />05121I2018 <br />05/21/2019 <br />EOe- NdEaOfSiNGLEDMIr <br />$ 1000000 <br />BODILY INJURY (Per persan) <br />$ <br />BODILY INJURY (Par accldeni) <br />$ <br />PROPERTYDAMAGE <br />a <br />."Went) <br />$ <br />S <br />UMBRELLA (JAB <br />E'XCESSLIAB <br />HCLAIMS-MADE <br />OCCUR <br />EACH OCCURRENCE <br />$ _ <br />$ <br />AGGREGATE <br />DEO I I RETENTION <br />C. <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />OFFICERRAEMBER EXCLUDED? CUTI'VE Y�'F"Nj <br />{Mandatory in NH) �� <br />If yes, describe under <br />DESCRIPTION OF OPERATbOHS below <br />N !A <br />N <br />(,,1g,3- 0200612 <br />09/0212017 <br />09f02RO18 <br />V SP7ARY 0TH- <br />f� <br />- <br />E.L. EACH ACCIDENT <br />$ 100�)D00 <br />E -L DISEASE - EA EMPLOYE <br />$ 1000000 <br />E -L 01 SEAS E - POLICY LIMIT <br />- - -.. -- <br />$ 1000000 <br />DESCRIPTION OF OPERATIONS 7LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be atlached if morespace Is required} <br />UtN I If IUA I t HULULN UAN (;LLLA I ION <br />Orange County Asset Management Services <br />Fax, <br />ACORD 25 (2016103) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />in iQRR- 71119; Ar`l)r711 ('nPDr%P A TInf I All ri.hfc —ar}reri <br />The ACORD name and logo are registered marks of ACORD <br />