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2019-257-E Visitors Bureau - Living Landscapes sidewalk
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2019-257-E Visitors Bureau - Living Landscapes sidewalk
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Last modified
5/6/2019 9:11:11 AM
Creation date
5/6/2019 9:04:21 AM
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Template:
Contract
Date
5/2/2019
Contract Starting Date
5/2/2019
Contract Ending Date
6/30/2019
Contract Document Type
Contract
Amount
$777.38
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R 2019-257 Visitors Bureau - Living Landscapes sidewalk
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2019
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DocuSign Envelope ID:7288E16E-A4E1-4773-81F4-89BCFFD294A1 <br /> LIVILAN-01 PJOHNSON <br /> '4�aRo CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) <br /> 5/2/2019 <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 License#1000009384 CONTACT <br /> NAME: <br /> Hub International Carolinas PHONE FAX <br /> PO Box 939 (A/C,No,Ext):(336)228-0541 (AIC,No):(866)590-4281 <br /> Burlington, NC 27216 ADDRESS: <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A:Selective Insurance Company of America 12572 <br /> INSURED INSURER B:Accident Fund Insurance Company of America 10166 <br /> Living Landscapes Inc INSURERC: <br /> 2077 S Main St INSURER D: <br /> Graham, NC 27253 <br /> INSURER E <br /> 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 OF INSURANCE INSD WVD M <br /> ADDLSUBR <br /> POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR IN SD VD M DD MM DD <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE � OCCUR S 2173803 7/12/2018 7/12/2019 DAMAGE TO RENTED 500,000 <br /> PREMISES Ea occurrence $ <br /> MED EXP(Any oneperson) $ 15,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 <br /> POLICY F7 JECOT- LOC PRODUCTS-COMP/OP AGG $ 3,000,000 <br /> OTHER: EBL AGGREGATE 31000,000 <br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 <br /> Ea accident $ <br /> X ANY AUTO S 2173803 7/12/2018 7/12/2019 BODILY INJURY Perperson) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $ <br /> HIRED NON-OWNED PROPER <br /> cctlenDAMAGE $ <br /> AUTOS ONLY AUTOS ONLY <br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 <br /> EXCESS LIAB CLAIMS-MADE S 2173803 7/12/2018 7/12/2019 AGGREGATE $ <br /> DED RETENTION$ 1,000,000 <br /> B WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> WCV 6114083 7/12/2018 7/12I2019 500,000 <br /> ANY CER/M MBER/PXCLUDE/EXECUTIVE ❑ E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 <br /> If yes,describe under 500,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Chapel Hill/Oran a Count Visitors Bureau THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> p g Y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 501 W.Franklin Street <br /> Chapel Hill,NC 27516 <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />
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