Orange County NC Website
DocuSign Envelope ID: ED487F6F-CC82-456D-AD07-A924ACB3D343 <br /> A ��0 CERTIFICATE OF LIABILITY INSURANCE DATE(M 08/22//2018 Y) <br /> 018 <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 CONTACT Brenda Durham <br /> NAME: <br /> PointeNorth Insurance Group,LLC PAHi�NNo Ext: (770)858-7540 C,No): (770)858-7545 <br /> PO Box 724728 E-MAIL bdurham@pointenorthins.com <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> Atlanta GA 31139 INSURERA: Cincinnati Insurance Company 10677 <br /> INSURED INSURER B: The Hartford-Rated by Multiple Companies 00914 <br /> Mauldin&Jenkins,LLC INSURER C: <br /> 200 Galleria Parkway SE INSURER D: <br /> Suite 1700 INSURER E: <br /> Atlanta GA 30339-5946 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 2018/2019 Master REVISION NUMBER: <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 /> TR INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> DAMAGE To_7CLAIMS-MADE � OCCUR PREM SES Ea occurrence)l <br /> $ 2,000,000 <br /> MED EXP(Any one person) $ 5,000 <br /> A Y ECP0258054 07/01/2018 07/01/2019 PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000.000 <br /> (Ea accident) <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED ECP0258054 07/01/2018 07/01/2019 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> X HIRED �/ NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY /� AUTOS ONLY (Per accident) <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 11,000,000 <br /> A EXCESS LIAB CLAIMS-MADE EXS0262115 07/01/2018 07/01/2019 AGGREGATE $ 11,000,000 <br /> DED I X1 RETENTION $ 0 $ <br /> WORKERS COMPENSATION X STATUTE EORH <br /> AND EMPLOYERS'LIABILITY Y/N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 <br /> B OFFICER/MEMBER EXCLUDED? ❑ NIA 20WECAI5405 08/31/2018 08/31/2019 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 <br /> If yes,describe under 500,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Orange County North Carolina ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 South Cameron Street <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 W' g Z� <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />