Orange County NC Website
DocuSign Envelope ID:4069CA99-5827-45B2-BE9F-9A011OC81475 <br /> A" CERTIFICATE OF LIABILITY' INSURANCE DATE05101/018 <br /> 0510,/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 BELOW. THIS <br /> CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR <br /> PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED Provisions or be endorsed. It <br /> SUBROGATION IS WAIVED, subject to the 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 endorsement s <br /> PRODUCER CONTACT <br /> NAME• LLLENT CONTACT CENTER <br /> FEDERATED MUTUAL INSURANCE COMPANY <br /> HOME OFFICE: P.O.BOX 32$ PHONE,No Exl:888-233-4949 A C No:507-446-4664 <br /> OVVATONNA,MN 55060 A DRESS:CLIENTCONTACTCENTER FEDINS.COM <br /> INSURERS)AFFORDING COVERAGE NAIL# <br /> INSURER A:FEDERATED MUTUAL.INSURANCE COMPANY 13935 <br /> INSURED 157-075-3 INSURER B: <br /> PHOENIX FIRE PROTECTION INC INSURER C., <br /> 2863 LEE AVE <br /> SANFORD,NC 27332-6205 INSURER D: <br /> INSURER E: <br /> INSURER R <br /> COVERAGES CERTIFICATE NUMBER:80 REVISION NUMBER.0 <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, EXCLUSIONS <br /> AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE DL SUBR POLICY NUMBER POLICY Err POLICY FXF LIMITS <br /> LTR INSR WVO MJDDIYYYY MMIDDIYYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> ED <br /> CLAIMS-MADE �OCCUR Pl ISES Ea oc urr nce $10Q,000 <br /> MED EXP(Any one person) EXCLUDED <br /> A N N 6057280 04/22/2018 04122/2019 PERSONALS ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> POLICY PRO LOC <br /> JECT PRODUCTS-COMPJOP AGO $2,000,000 <br /> X <br /> OTHER: <br /> AUTOMOBILE LIABILITY 'COMBINED SINGLE LIMIT $1,000,000 <br /> Eaac'e I <br /> X ANY AUTO BODILY INJURY(Perperson) <br /> OWNED AUTOS ONLY SCHEDULED <br /> A AUTOS N N 6057280 04l221201$ 04l2212413 BODILY INJURY(Per accident) <br /> HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY p e r <br /> X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 <br /> A EXCESS LIAR CLAIMS-MADE N N 61057281 04/22/2018 04/22/2019 AGGREGATE $5,000,000 <br /> DED RETENTION <br /> WORKERS COMPENSATION X PER STATUTE I OER <br /> AND EMPLOYERS'LIABILITY Y f N <br /> ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000 <br /> A OFFICERJMEMBER EXCLUDED? NIA N 6057284 04/22/2018 04/22/2019 <br /> E.L DISEASE-EA EMPLOYE E $1,000,000 <br /> (Mandatory In NH) <br /> If yes,describe under E.L DISEASE•POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS below $1,000,000 <br /> DESCRIPTION OF OPERATIONS J LOCATIONS J VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is requiredl <br /> POLICY COVERAGE AS OF 04/29/2.018 MAY 20118 <br /> CERTIFICATE HOLDER CANCELLATION <br /> 151-075-3 800 <br /> ORANGE COUNTY ASSET MANGEMENT SERVICES SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 131 W MARGARET LN THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> HILLSBOROUGH, NC 27278-2547 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> 0 1908-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />