Orange County NC Website
DocuSign Envelope ID:7CF26EB6-C8A1-4FA5-BB42-042EFBC099BD <br /> DATE(MM/DD/YYYY) <br /> AC"RiDO CERTIFICATE OF LIABILITY INSURANCE <br /> �� 10/20/2018 8/28/2018 <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 Lockton Insurance Brokers,LLC NAM <br /> NAMEE:: <br /> CA License#OF 15767 PHONE I FAX <br /> Three Embarcadero Center,Suite 600 E AIL Ext A/C No <br /> San Francisco CA 94111 ADDRESS: <br /> (415)568-4000 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:National Fire Insurance Co of Hartford 20478 <br /> INSURED Granicus,Inc. INSURER B:The Continental Insurance Company 35289 <br /> 1418581 707 17th Street,Suite 4000 INSURER C: <br /> Denver CO 80202-343 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES GRAINOI CERTIFICATE NUMBER: 15579487 REVISION NUMBER: XXxxXXX <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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP <br /> LTR POLICY NUMBER MM DDIYYYY MM/DIIYYYY LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY N N 6043664103 10/20/2017 10/20/2018 EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE U OCCUR _PR_M SES Ea occurrence $ 1 OOO OOO <br /> MED EXP(Any one person) $ 15,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY jE � LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> I OTHER: $ <br /> $ AUTOMOBILE LIABILITY N N 6043664084 10/20/2017 10/20/2018 COMBINED SINGLE LIMIT $ <br /> Ea accident 1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ XXXXXXX <br /> AUTOS ONLY <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ XXXXXXX <br /> • HIRED X NON-OWNED PROPERTY DAMAGE $ XXXXXXX <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> • Comp$100 D & Coll$1,000 D d $ XXXX7C x <br /> UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ XXyCxXXX <br /> DED RETENTION$ $ XXXXXXX <br /> WORKERS COMPENSATION PER OTH- <br /> B AND EMPLOYERS'LIABILITY N 6043364067 AOS) 10/20/2017 10/20/2018 X STATUTE ER <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N N/A <br /> 6043364070(CA) 10/20/2017 10/20/2018 E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Evidence of Insurance <br /> CERTIFICATE HOLDER CANCELLATION <br /> 15579487 <br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 228 South Churton Street, Suite 300 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Hillsborough,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRASENTATIVE <br /> A�� <br /> ©1988-2015 ACORD CORPORATI . All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />