Orange County NC Website
Browse       Search
DocuSign Envelope ID:466BC84F-2491-482F-9ECF-E665A2F18724 <br /> ACa GATE(MMlDDIYYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 11/05/2018 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder In lieu of such endorsements). <br /> PRODUCER CONTACT <br /> NAME: <br /> PHONE FAY <br /> AfC NO: <br /> Andrew F.Jones E-MAIL <br /> ADDRESS- <br /> 729 W NC HIGHWAY 54 INSURERS AFFORDING COVERAGE NAIC# <br /> ❑URHAM NC 27713 INSURERA: NATIONWIDE PROPERTY AND CASUALTY 1NSUF 37877 <br /> INSURED INSURERS: <br /> I NSU RER C: <br /> CIVIL CONSULTANTS,INC INSURERII: <br /> 3708 LYCKAN PKWY STE 201 INSURERE: <br /> DURHAM NC 27707-2586 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION 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 INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MMro MMfD <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO REN <br /> CLAIMS-MADE ❑OCCUR PREMISES Ea occurrence $ 300,000 <br /> ME EXP(Arty one person) $ 5.000 <br /> A ACP BPCK3046630836 0412412D18 04/24/2019 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY❑PRO- LOC PRODUCTS-COMPIOPAGG $ 2,000,000 <br /> OTHER: $ <br /> AUTOiMOBILE LIABILITY COMBINED SINGLE L[Mrr $ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL DINNED SCHEDULE[) BODILY INJURY[Per accident] $ <br /> AUTOS OS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Per accident <br /> UMBRELLA LAB HOCCUR EACH OCCURRENCE $ <br /> EXCESS LIM CLAIMS-MADE AGGREGATE $ <br /> DED I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LABILITY YIN TATUTE ER <br /> ANYPROPREETORIPARTNERIFXECLMVE ❑ N 1 A E.L.EACH ACCIDENT $ <br /> RM OFFICEEMBER EXCLUDED? <br /> (Mandatory En NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101,Additional Remarks Schedule,may ba attachad if more space is raquiradI <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County <br /> AUTHORIZED REPRESENTATIVE <br /> PO Box 8181 Diane Burgess <br /> Hillsborough NC 27278 , gr�� <br /> ©1988-2014 ACORD CORPORATIION. All rights reserved. <br /> ACORD 25(2014101) The ACDRD name and logo are registered marks of ACOR❑ <br />