Orange County NC Website
DocuSign Envelope ID:7D379662-2FBB-4A13-AA80-E3B94B1ABCFB <br /> CERTIFICATE OF LIABILITY INSURANCE F DA09/05/20 8) <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 WAIVEDt subject to the <br /> 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 /> PRODUCER NAME•NTACT FLIP Program Support <br /> Veracity Insurance Solutions,LLC. PHONE FAX <br /> [JI1,C E'4R" (844)-520-6992 (A±C.No): <br /> 260 South 2500 West,Suite 303 EFSS: info @fliprogram.com <br /> Pleasant Grove UT 84062 INSURER(SI AFFORDING COVERAGE NAICO <br /> INSURER A: Great American Alliance Insurance Co. 26832 <br /> INSURED INSURER 8: <br /> Spanglish -INSURER C: <br /> 4637 Tollington Dr INSURER D: <br /> Raleigh NC 27604 INSURER E: <br /> INSURER F i <br /> COVERAGES CERTIFICATE NUMBER: 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 IADDL SUER ROLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER OWL60,YYY MWDD LIMITS <br /> GENERAL LIABILITY 1,000,000 <br /> EACH OCCURRENCE 5 <br /> X COMMERCIAL GENERAL LIABILITY P'REA M SES(Ea Eocccw m _ s 300,000 <br /> X <br /> CLAIMS-MADE X OCCUR MED EXP(Any arts person) S 5,000 <br /> A PL1744427-FO50341 07/0712018 07/07/20191 PERSONAL&ADV IWURY S 1,000,000 <br /> GENERAL AGGREGATE S 2,000,000 <br /> G£NL AGGREGATE LIMITAPPLIESPER: PRODUCTS-COMPIOPAGG S 2,000,000 <br /> X POLICY PRO ._ LOC ANIMAL BAILEE 'S <br /> AUTOMOBILE LIABIUTY ! C£OMBIR StlNGLE LIMIT S <br /> ANY AUTO BODILY INJURY(Per person) S <br /> ALL OWNED I SCHEDULED BODILY INJURY(Per accident) S <br /> AUTOS AUTOS _ <br /> NON-OWNED PROPERTY DAMAGE <br /> _ HIRED AUTOS AUTOS Per eocidenl S <br /> �S <br /> UMBRELLA L.IAB OCCUR F F EACH OCCURRENCE_ S <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE S <br /> DFO I I RETENTIONS S <br /> WORKERS COMPENSATION WC STATU- OTH <br /> AND EMPLOYERS'LIABILITY YIN TORY LIIu11TR" ER <br /> ANY PROPRIETOFVPARTNMEXFCUTiVE F7 N NI AF <br /> E.L.EACH ACCIDENT S <br /> OFFICEIMEMBER EXCLUDED? --_ --"""-"------ <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S <br /> If yes,describe under EL.DISEASE-POLICY LIMIT S <br /> --DESCRIPTION OF OPERATIONS telaw <br /> �I <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Certificate holder had been added as additional insured regarding the above mentioned policy per attached <br /> Additional Insured- Designated Person or Organization (CG 20 26 Ed.04 13) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> NC Cooperative Extension ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsboro,NC 27278 AUTHORIZED REPRESENTATIVE <br /> CtJ 1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2D141D1) The ACORD name and logo are registered marks of ACORD <br /> INS025(201401) <br />