2019-017-E AMS - First Fire Protection Hillsborough Commons

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DocuSign Envelope ID:891 DF1 DD-EF0E-4B48-A9F1-20077DB1 55EE AC o0 12/14/2018 CERTIFICATE OF LIABILITY INSURANCE DATE`M /201$ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL.INSURED,the pollcy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorseme s). NTACT PRODUCER 7RE Larry F Hodges 's Ailnsurance 252 937-2$16 FAX Ne: 252-937-6301 PO Box 2444 arryhodgewaiins.us INSURE S AFFORDING COVERAGE NAIC# FAYETTEVILLE NC 28302 Mt Hawley Insurance Co.INSURED Mt Hawley Insurance Co.FIRST FIRE PROTECTION INC Integon General Insurance Co. PO BOX 10594 INSURER D:Travelers Property Casualty Co.of America INSURER E: RALEIGH NC 27605-0594 INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS DDL SUBR POUCY EFF POLICY EXP LIMITS TYPE OF INSURANCE POLICY NUMBER IMMID IMMJ I COM MERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �Xl OCCUR DAMAGE TO EaENTErens $ 500,000 MED EXP(Any one person) $ 5,000 A X X PGA0003445 09/05/2018 09/05/2019 PERSONAL&ADVLNJURY $ 1,000,000 GF=WL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,D00,000 X POLICY PRO- LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILRY Ea accidenS $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ C OWNED SCHEDULED X X 2004999809 05/08/2018 05/08/2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS NON-OWNED pAMAGE HIRED NONNED Per accident $ AUTOS ONLY AUTOS ONLY MEDICAL PAYMENTS $ 1,0()0 UMBRELLALIA15 1 X1 OCCUR EACH OCCURRENCE $ 2,000,000 B X EXCESS LIAR CLAIMS-MADE XGA0001548 09/05/2018 09/05/2019 AGGREGATE $ 2,000,000 PRODUCTS COMPLETED $ 2,000,000 DED RETENTION$ IER WORKERS COMPENSATION STATUTE ER AND EMPLOYERS'LIABILITY ANYPROPRIE CUT TORIPARTNEWEXEIVE YIN NIA A ASSIGN25691110 08/15/2018 08/15/2019 D E.L.EACH ACCIDENT $ 500,0 OFFICERIMEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500,000 (Mandatory in NH) If pp,S,desaibe under E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below null DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,AddWonal Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION a County,NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough NC 27278-8181 AUTHORIZEDREPRESENTATIVE r ContactName:Allison Cooper ContactPhone:919-245-2625 C OqJ LARRY F HODGE5 irEt�1 0 1988-2015 ACORD ORPO TION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD