Orange County NC Website
DocuSign Envelope ID: F77D8FCA-4488-4116-8F56-FB42C8DEEE8F <br /> 6c CERTIFICATE OF LI►A BILITY INSURANCE DATE 031%120118 <br /> � 031tE12(}18 <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 pollcy(Ies)must be endorsed. If SUBROGATION IS WAIVED,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 ondorsement(s). <br /> PRODUCER CO�y TR F <br /> NAME: Vol,Brame_ <br /> Will Brame,Agent ?HONE, xla;d19 527-5836 -- w rro,__ <br /> AuAILk <br /> Walker Insurance Agency MAIL <br /> vbrameQalinus.co —_..__-. _ <br /> 430 East Williams Street INSURTSRM AFFORDING COVERAGE NAIC a._ <br /> Apex NC 27602 INSURER A Naulilius Insurance Company - <br /> INSURED INSURER s; NatlonWde Mutual Insurance <br /> Apex Fire Systems <br /> PO BOX 879 INSURER C: Evanston Insurance <br /> INSuRRO:Sternal-InsuranceCompany - <br /> Sanford NC 27331 INSURER E: — - --INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:31618 REVISION NUMBER: NA <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 ALI. THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> IMSR ....- -_....,.-. _. ADF1L3${l13R PPLICY EFF PGLlCY INSR LTR TYPE OF IN$IPRANCE POLICY NUMBER MMIDG MirVGDIYYYY LIMIT$ <br /> GENERAL LIABILITY EACH OCCURRENCE s 2,000,000 <br /> ._ <br /> x COMMERCIAL GEN RAL LIABILITY 9i DRQM S YO t2EN1'Et� <br /> r 1I PREMISES{Ea occL:rtenca) 5 <br /> CLAIMS-NFADE I OCCUR I MED EXp(Arty rile person _ S 100.004 <br /> A — _ ; NC3098176 0910112017 09101/2018 PERSONAL&A_OV INJURY S 2 QQ._00O <br /> _ l GENERALAGGREGATE s4,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: � JJ� PRL}DUCTS-CCIMPIOP AGG SA ()00 <br /> X POLICY, IRO- �'L_OC 1 S <br /> AUTOMOBILE LIABILITY I COMBILED 51N©tE LIMIT <br /> ANY AUTO ' BODILY INJURY(Per person) i S <br /> ALLOVJNED SCHEDULED <br /> X i IIODILY INJURY(Per accident) S <br /> B HRW N014-OMED jACP QA 814019731147 '09I0112017 091011201$ PROPERTY DAMAGE -- <br /> x tiIREDAUT65 x AUTOS I ! Per accident S <br /> 11 s <br /> X UMBRELLAUAB X OCCUR �F! I EACH OCCURRENCE $ 1,000,000 <br /> C EXCESS LIAS CLAIMS-MADE j EXUA081621 11/0112017 111111112018 AGGREGATES 1,000,000�- <br /> MID RETENTIONS S <br /> 3WORKERSCOMPENSAVO9 �( TM STATU- D�`-„ <br /> ANA EMPLOYERS"LIABILITY <br /> D ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT _ S 1.000 000 <br /> OFFLCFJMEM13ER EXCLUDED? ® NIA I ;WC671872'89 49f0'i f2l?17 09f411201$ .. <br /> (I.faAdilnry E @NISI I E.L,OI$EASE-EA . <br /> EMPLDYE $ 1.000,OOD <br /> If yea,da5dbe Under ; <br /> I E.L.DISEASE-POLICY LIMIT S 1,000,000 <br /> I I i <br /> DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES(Attach ACORD 10t,Addlnbnal Rar@ar%!Schedule,It more spatu Is regulredl � <br /> Fire protection sates,installation,and services <br /> Automobile as it,pertains to the named additional insureds operations In Connection with the above <br /> CERTIFICATE HOLDER CANCELLATION <br /> orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES B CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> PO BGX 8181 ACCORDANCE VVITH THE POLICY PROVISIONS, <br /> 919-732.8181 AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> ©1988-21710 AC RD CORPORA PON. All rights reserved. <br /> ACORD 25(2014105) The ACORD name and logo are registered marks of ACORD <br />