2013-430 Emergency Svc - Orange Grove Fire Company for Emergency Medical Services Substation

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ORANG-1 OP ID: HL CERTIFICATE OF LIABILITY INSURANCE DATE(M8/20 3 `...�--� 10/08/2013 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 policy(ies) must 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 endorsement(s). CNACT PRODUCER Phone:919-755-1401 NAME: VFIS of North Carolina Fax:919-755-1125 aCNN Ext: AX No P.O.Box 12825 Raleigh,NC 27605 ADDRIESS: W.Cloyce Anders INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:American Alternative Ins.Co. 19720G INSURED Orange Grove Vol Fire Co Inc INSURER B: Tommy Holmes,Chief 6800 Orange Grove Road INSURER C Hillsborough,NC 27278 INSURER D: INSURER E: INSURER F: 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. DDLSUBR INSR TYPE OF INSURANCE POLICY NUMBER MM/DDIYYYY POLICY/ D/YYYY LIMITS LTR GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00-DAMAGE TO RFNTEL) A X COMMERCIAL GENERAL LIABILITY TR-2055241-06 07/22/2013 07122/2014 PREMISES Ea occurrence $ 1,000,00 CLAIMS-MADE FK OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 3,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,00 JECT POLICY PRO X LOC $ AUTOMOBILE LIABILITY Ea acccidentSINGLE LIMIT $ 1,000,00 • X ANY AUTO CM-1053220-06 07/22/2013 07/22/2014 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ X AUTOS X AUTOS NON-OWNED PROPERTY DAMAGE $X HIREDAUTOS AUTOS Per accident X Comp$100 X Coll$500 $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,00 • X EXCESS LIAB CLAIMS-MADE TR-2055241-06 07/2212013 07122/2014 AGGREGATE $ 2,000,00 DED F RETENTION$ $ WORKERS COMPENSATION WC ST'MIT OTH- AND EMPLOYERS'LIABILITY YIN T RY LIMIT R ANY PROPRIETOR/PARTNER/EXECUTIVE❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ • Real Property TR-2055241-06 07/22/2013 07/22/2014 Building GR • Personal Property TR-2055241-06 07122/2013 07/22/2014 Contents Blkt R DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Management Liability $1,000,000 Each Wrongful Act, $3,000,000 Aggregate. Commercial Blanket Bond $25,000 limit. Portable Equipment is on Guaranteed Replacement Cost with a $100 deductible and includes portable firefighting, ambulance and rescue-related equipment owned or furnished for your regular use. See notes for property information. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. P.O.Box 8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD