2019-093-E AMS - Mobile Communications Vesta

Browse Search

DocuSign Envelope ID:OOFD3321-7305-45B3-A55A-6724FOEOA6C5 A C R e DATE(MMIDD/YYYY) _ CERTIFICATE OF LIABILITY INSURANCE 612 112 01 8 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 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 endorsements). ONTACT PRODUCER Stephens Insurance, LLC NAME Stephanie Jones 111 Center Street, Suite 100 A"°N o 501 377-3445 FAX No; 501 210-4627 Little Rock, AR 72201 E-MAIL ADDRESS: Ste hanie.Jones Ste hens.com INSURER(S)AFFORDING COVERAGE NALC 0 www.stephens.com INSURERA: Massachusetts Bay Insurance Company 22306 INSURED INSURER B. The Hanover Insuranoe Company_ 22292 Mobile Communications America, Inc. INSURERC: Allmerica Financial Benefit Insurance Co 41640 & Subsidiaries 885 Cripple Creek INSURERD; _ Lawrenceville GA 30043 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER.- 43742355 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, TFRM OR CONDITION ❑F 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. INSR TYPE OF INSURANCE ADDLSl1BR POLICYNUMBER IVPIMIDDIYYYY MM?DDOLICYEFF Y EXP LTR 7YYYY LIMITS A V COMMERCIAL GENERAL LIABILITY TDT-D351274-01 8/23/2018 8/23/2019 EACH OCCURRENCE $1 000 000 CLAIMS-MADE F OCCUR PREMiS S Ea ocrurcence $100 000 MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1 000 000 GERLAGGREGATELI MIT APPLIES PER: GENERAL AGGREGATE $2.000,000 POLICY[7]jR O- LOC PRODUCTS-COMPIOP AGG s2,000,000 OTHER' $ A AUTOMOBILELIABILITY ADT-D342535-01 8/23/2018 8/23/2019 CO BINEDISINGELIMIT $1040000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY OSHIRED NON-OWNEO pROPERTYOAMAGE $ AUTOS ONLYLAUT AUTOS ONLY Per aoddentGara ekes eal Llabilitv $ B UMBRELLA LIAR M,/ OCCUR UHT-0351276-01 8/23/2018 8/23/2019 EACH OCCURRENCE $10 000 000 EXCESS I. CLAIMS-MADE Commercial Follow AGGREGATE $10 000 000 DE❑ I VI RETENTIONsNII I Form Policy $ C WORKERS COMPENSATION W2D-D343901-01 8/23/2018 8/23/2019 �/ STATUTE ER AND EMPLOYERS'LIABILITY ANYPROPRIETORIPARTNERIEXECUTIVE YIN NIA E.L.EACH ACCIDENT $1 000 000 OFF ICERIMEMSERIXCLUDE67 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ I}yes,dSecribe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 OOO OOO B Professional Liability LHT-D351277-01 8/23/2018 8/23/2019 Each Claim Limit$2,000.000 Aggregate Limit$2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 1e1,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Orange County Emergency Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE PO Box 81 S 1 ACCORDANCE W THTHE POL CYPROVISION WILL BE DELIVERER IN 200 S Cameron Street Hillsborough NC 27278 AUTH0RrZUDREPRESENTATiVE Sian Payne ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and Toga are registered marks of AGOR❑ 43742355 I ]g119 Master Certificate I Stephanie Jones 18/21/2618 5;3903 PM {CI]TI I Page 1 vP 2