Orange County NC Website
DocuSign Envelope ID:366FDAE2-AD4E-4249-B7C6-59DC3A919179 NEXSEPRU <br /> A m DATE(MMIDD/YYYY)do,Ra CERTIFICATE OF LIABILITY INSURANCE <br /> 1/25/2019 <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 NAME: Michelle Black <br /> Commercial Lines-(843)573-2600 PHONE g54-529-1608 FAX 866-358-8252 <br /> A/C No Ext: AIC No <br /> USI Insurance Services LLC E-MAIL michelle.black@usi.com <br /> 176 Croghan Spur,Suite 300 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Charleston,SC 29407 INSURER A: Scottsdale Insurance Company 41297 <br /> INSURED <br /> INSURER B <br /> Nexsen Pruet, PLLC <br /> INSURER C <br /> 4141 Parklake Avenue,#200 INSURER D: <br /> INSURER E: <br /> Raleigh,INC 27612 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 13845987 REVISION NUMBER: See below <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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER MMIDD/YYYY MMIDD/YYYY <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S <br /> DAMAGE CLAIMS-MADE OCCUR FIR SESOEa o'currDence S <br /> MED EXP(Any one person) S <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S <br /> POLICY D PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG S <br /> OTHER $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> S <br /> UMBRELLALIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? ❑ NIA <br /> (Mandatory in NH) EL DISEASE-EA EMPLOYEE S <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $ <br /> A Lawyers Professional Liability LWS0000635 07101/2018 07/01/2019 $20,000,000 Per Claim <br /> $40,000,000 Aggregate <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange Co.Attorney's Office SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Attn.John Roberts,County Attorney ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 S.Cameron St. <br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE} <br /> �l tea. <br /> The ACORD name and logo are registered marks of ACORD @ 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) <br />