Orange County NC Website
DocuSign Envelope ID: EED1436F-A6DD-4OE9-BE68-FFBF6AF84800 <br /> AGRIW-1 <br /> ,4Cv�o CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDCIYYYY} <br /> 01/0412019 <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 endorsements. <br /> PRODUCER 919-556-3698 CD TACT Dan Stroud,GIG,AAI <br /> Hartstield&Nash Agency,Inc. PHONE 919-666-3698 FAX 919�15B-8T58 <br /> Post Office Box 1109 IAIC,No,Ext: ArC,No <br /> Wake Forest,INC 27588 EMI an art'$ 0 -naS .Com <br /> Don Stroud,CiC,AAI <br /> INSURERISI AFFORDING COVERAGE NA1C4 <br /> INSURERA:SGIOCtiVe Insurance Company 39926 <br /> INSURED Agri-Waste Technology Inc INSURER B:Accident Fund Insurance Co 10166 <br /> 501 N.Salem St Ste 203 <br /> Apex, NC 27502 INSURERC: p Endurance American Specialty 41778 <br /> INSURER D <br /> INSURER E <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER; VISION 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 /> INSR TYPE OF INSURANCE ADDL SU8 POLICY NUMBER POLICY EFF POLICY EXPLTR bbrfyyyt LIMITS <br /> A COMMERCIAL GENERAL LMILITY EACH OCCURRENCE 2,000,000 <br /> CLAIMS-MADE �OCCUR S 2253659 01M812019 01118/2020 DAMA1'SESM ocw 50,000 <br /> X Business Owners MED EXP(Any oneperson) 10,OOD <br /> PERSONAL&ADV INJURY 2,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,DOD <br /> POLICY j LCC PRODUCTS•OOMPIOP AGG 4,000,000 <br /> OTHER' <br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 11000,000 <br /> X ANY AUTO S 2253659 01/18/2019 0111812020 BODILY INJURY Perperson) <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILYBO�DILY INJURY Per accident <br /> AUTOS ONLY AUTOS ONLY PeOen MACE <br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE 2,000,000 <br /> EXCESS LIAB CLAIMS-MADE S 2253659 01118/2019 01118/2020 AGGREGATE $ 2,000,600 <br /> DED X RETENTIONS 0 <br /> B WORKERS COMPENSATION X PER OTH- <br /> STATUTE ER <br /> AND EMPLOYERS'LIABILITY Y I N <br /> ANY PROPRIETORIPARTNERIEXECUMVE CV6138339 01/18/2079 01/18/2020 E.L.EACH ACCIDENT 1,000,000 <br /> EXCLUDED? NppaFnICERd1 M M IA <br /> atYN E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> IT rs,describe under 1,000,000 <br /> CRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT <br /> C Professional Llab ECC10101303500 08/2212018 08/22/2018 per claim 4,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES{ACORD 101,Additlonal Remarks Schedule,may be attached IF more space Is(equlredl <br /> The general liability policy includes a blanket automatic additional <br /> insured endorsement that provides additional insured statLIS to the <br /> certificate holder only when there is a written contract in place between <br /> the named insured and the certificate holder that requires such status <br /> CERTIFICATE HOLDER CANCELLATION <br /> COLD761 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Caldwell Banker Advantage ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 7610-100 Six Forks Rd <br /> Raleigh, NC 27616 AUTHO RIZED RE P RES EN TATIV E <br /> ACORD 25 t2016I03) CQ 1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACOR❑ <br />