Orange County NC Website
DocuSign Envelope ID:833B4E95-E640-4B80-9087-123603321132 <br /> Q <br /> '4 CERTIFICATE OF LIABILITY INSURANCE DATEOHIDDI4117,2{k18 <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 BELOW, THIS <br /> CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS), AUTHORIZED REPRESENTATIVE OR <br /> PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policyfies) must have ADDITIONAL INSURED Provisions or be endorsed. if <br /> SUBROGATION IS WAIVED, subject to (he terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br /> certificate does not confer rights to the certificate holder in lieu of such endorsements. <br /> PRODUCER CONTACT <br /> FEDERATED MUTUAL INSURANCE COMPANY PH CLIENTCONTACT CENTER <br /> HOME OFFICE:P.O.BOX 328 AICNL Exk).888-33'3-4949 FAX No):507•-4464664 <br /> OWA7DNNA,MN 55060 AAIL <br /> DDRESS:CLIENTCONTACTCENTER ct FEDINS.COM <br /> MSURER(SI AFFORDING COVERAGE NAIL# <br /> INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 <br /> INSURED --- 348-705.5 INSURER B: <br /> TRADEMASTERS SERVICES INCORPORATED INSURER c: <br /> 5012 NEAL RD — <br /> DURHAM,NC 27705-2362 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:34 REVISION NUMBER:2 <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- NOMTHSTAN13ING 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,EXCLUSIONS <br /> AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE DL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> L INSR WVD MMIODIYYYY MMIDDIYYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE OCCUR PREEMISFS TO RENTEDSiO0,000 <br /> M€D EXP(Any one person} EXCLUDED <br /> A Y N 9337203 0211112018 0211112019 PERSONALS ADV INJURY $1,000,000 <br /> FGEOTHER: <br /> N'L AGGREGATE LIMIT APPLI€S PER: GEN€RAL AGGREGATE $2,000,QOt?OLICY �JECT ❑LOC PRODUCTS-COMPIOP AGO $2,DDG.000 <br /> AUTOMOBILE LIABILITY - po"I INED SINGLE LIMIT $1,000,000 <br /> Ea accidr <br /> X ANY AUTO BODILY INJURY(Per personl <br /> AWNED AUTOS ONLY SCHEDULED <br /> A AUTOS Y N 9337203 02/11/2018 02/11/2019 BODILY INJURY(Peraccideni) <br /> HIRED AUTOS ONLY RON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY Per acc de <br /> 1 <br /> X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,0 0,000 <br /> A EXCESS LIAR CLAIMS-MADE N N 9337204 02/11/2018 02/11/2019 AGGREGATE $5,GD0,0D0 <br /> OED I I RETENTION <br /> WORKERS COMPENSATION X PER STATUTE OAR <br /> AND EMPLOYERS'LIABILITY YIN <br /> ANY PROPRIETORMARTNERIEXECUTIVE E.L EACH ACCIDENT $1,000,DDD <br /> A OFFICERIME.MBER EXCLUDEDT N I A N 9337205 02/11/2018 02/1112019 E.L DISEASE•EA EMPLOYEE <br /> (MandMory In HHJ $1,000,000 <br /> If yes,describe under - <br /> DESCRIPTION OF OPERATIONS beteW E.L DISEASE-POLICY LIMB $1,00D,0170 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101.AddlIlDnal Remarks Schedule,may be atlacthed ll mare space is.requiredl <br /> SEE ATTACHED PAGE <br /> CERTIFICATE HOLDER CANCELLATION <br /> 348-705-5 342 <br /> ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> HILLSBOROUGH,NC 27278-8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> 0 1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2018103) The ACORD name and logo are registered marks of ACORD <br />