Orange County NC Website
The ACORD name and logo are registered marks of ACORD <br />CERTIFICATE HOLDER <br />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2014/01) <br />AUTHORIZED REPRESENTATIVE <br />CANCELLATION <br />DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE <br />LOCJECTPRO-POLICY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />OCCURCLAIMS-MADE <br />COMMERCIAL GENERAL LIABILITY <br />PREMISES (Ea occurrence)$DAMAGE TO RENTED <br />EACH OCCURRENCE$ <br />MED EXP (Any one person)$ <br />PERSONAL & ADV INJURY$ <br />GENERAL AGGREGATE$ <br />PRODUCTS - COMP/OP AGG$ <br />$RETENTIONDED <br />CLAIMS-MADE <br />OCCUR <br />$ <br />AGGREGATE$ <br />EACH OCCURRENCE$UMBRELLA LIAB <br />EXCESS LIAB <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS <br />PERSTATUTE OTH-ER <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />$ <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />(Mandatory in NH) <br />OFFICER/MEMBER EXCLUDED? <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNEDSCHEDULED <br />HIRED AUTOS NON-OWNEDAUTOSAUTOS <br />AUTOS <br />COMBINED SINGLE LIMIT <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE $ <br />$ <br />$ <br />$ <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 />INSD <br />ADDL <br />WVD <br />SUBR <br />N / A <br />$ <br />$ <br />(Ea accident) <br />(Per accident) <br />OTHER: <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 WAIVED, subject to <br />the 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 />COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: <br />INSURED <br />PHONE(A/C, No, Ext): <br />PRODUCER <br />ADDRESS:E-MAIL <br />FAX(A/C, No): <br />CONTACTNAME: <br />NAIC # <br />INSURER A : <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />INSURER(S) AFFORDING COVERAGE <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />12/12/2014 <br />Rutherfoord, A Marsh & McLennan Agency LLC Co. <br />1001 Haxall Point, Suite 800 <br />Richmond VA 23219 <br />Draper Aden Associates, Inc. <br />2206 South Main St Ste A <br />Blacksburg VA 24060 <br />Westfield Insurance Company <br />Travelers Indemnity Company <br />24112 <br />25658 <br />804-780-0611 <br />certificates@rutherfoord.com <br />DRAPEADEN1 <br />1595772671 <br />ACMM51327712/1/20142/1/2015 1,000,000 <br />500,000 <br />10,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />X <br />X <br />XX <br />A <br />X <br />XX <br />CMM5132771 2/1/20142/1/2015 1,000,000 <br />AX <br />X <br />X <br />0 <br />CMM51327712/1/20142/1/2015 5,000,000 <br />5,000,000 <br />B4017T4772/1/20142/1/2015 X <br />1,000,000 <br />1,000,000 <br />1,000,000 <br />Orange County North Carolina <br />1207 Eubanks Road <br />PO Box 17177 <br />Chapel Hill NC 27516 <br />DocuSign Envelope ID: 5390EF36-4AA1-4377-8652-50D30B3AF28E