Orange County NC Website
TheACORDnameandlogoareregisteredmarksofACORD <br />CERTIFICATE HOLDER <br />©1988-2014ACORDCORPORATION.Allrightsreserved. <br />ACORD25(2014/01) <br />AUTHORIZED REPRESENTATIVE <br />CANCELLATION <br />DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE <br />LOCJECTPRO-POLICY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />OCCURCLAIMS-MADE <br />COMMERCIAL GENERAL LIABILITY <br />PREMISES(Eaoccurrence)$DAMAGE TO RENTED <br />EACHOCCURRENCE$ <br />MEDEXP(Anyoneperson)$ <br />PERSONAL&ADVINJURY$ <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMP/OP AGG $ <br />$RETENTIONDED <br />CLAIMS-MADE <br />OCCUR <br />$ <br />AGGREGATE $ <br />EACHOCCURRENCE$UMBRELLA LIAB <br />EXCESS LIAB <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS <br />PERSTATUTE OTH-ER <br />E.L.EACHACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />$ <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />Ifyes,describeunder <br />DESCRIPTION OF OPERATIONS below <br />(Mandatory in NH) <br />OFFICER/MEMBER EXCLUDED? <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALLOWNEDSCHEDULED <br />HIRED AUTOS NON-OWNED <br />AUTOSAUTOS <br />AUTOS <br />COMBINED SINGLE LIMIT <br />BODILYINJURY(Perperson) <br />BODILYINJURY(Peraccident) <br />PROPERTY DAMAGE $ <br />$ <br />$ <br />$ <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 />INSD <br />ADDL <br />WVD <br />SUBR <br />N / A <br />$ <br />$ <br />(Eaaccident) <br />(Peraccident) <br />OTHER: <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />COVERAGESCERTIFICATENUMBER:REVISIONNUMBER: <br />INSURED <br />PHONE(A/C, No, Ext): <br />PRODUCER <br />ADDRESS:E-MAIL <br />FAX(A/C, No): <br />CONTACTNAME: <br />NAIC# <br />INSURER A : <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />INSURER(S)AFFORDINGCOVERAGE <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 />INS025 (201401) <br />1/31/2018 <br />Insurance Management Consultants, Inc. <br />P.O. Box 2490 <br />DavidsonNC28036 <br />Cayla Nugent <br />(704)799-1600 (704)799-2955 <br />cayla@imcipls.com <br />The John R. McAdams Company, Inc. <br />P.O. Box 14005 <br />Research TriangleNC27709 <br />RLI Insurance Company13056 <br />2/5/18 Renewal <br />A Professional Liability RDP00315122/5/20182/5/2019 Per Claim $2,000,000 <br />Aggregate $4,000,000 <br />Jeff Todd/NF <br /> Orange County Planning and <br /> Inspections Department <br /> P.O. Box 8181 <br /> 131 W. Margaret Lane <br /> Hillsborough, NC 27278 <br />hfleming@orangecountync.go <br />DocuSign Envelope ID: 8135153B-BEF8-4B98-B340-8C3E04319A63