Orange County NC Website
DocuSign Envelope ID:90C19616-EF64-43BA-87A3-7B963CC866FB <br /> DATE(MMIDDIYYYY) <br /> AC"J?L> CERTIFICATE OF LIABILITY INSURANCE <br /> ��. 05/0112019 <br /> THIS CERTIFICATE IS ISSUED AS A NIATTER OF INFORNIA71ON ONLY AND CONFERS NO RIGHTS UPON THE CERTEFICATE 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 <br /> NAME: Carla Moore <br /> Colonial Insurance Agency Hillsborough nr'C' (919)732 2191 alc No; (919)732 2192 <br /> EMAIL 0 caa colonial-a enc <br /> ADDRESS: C� � Y•com <br /> Po Box 490 INSURER 8 AFFORDING COVERAGE NAIL# <br /> Hillsborough NC 27278 1N$URERA; Cwvners Ins Co 32700 <br /> INSURED INSURER B <br /> Greer and Associates Inc dba Signarama INSURER C <br /> Raleigh-We st-RTP and of Durham,Design Element of NC INSURER D <br /> 3702 Hillsboroigh Rd Ste 1 INSURER E <br /> Durham NC 27705 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. NOTW"STANDING 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 /> NSR ADOLSUBR POLICY E <br /> LTR TYPE OF INSURANCE INSD WVQ POLICY NUMBER MWDDIYYYY) fMM1DDfYYYY1 LIMITS <br /> X cOMMERCIALGENERALLIABILITY EACH OCCURRENCE $ 1000000 <br /> DAMAGE TO RENT EIT- <br /> CLAIMS-MADE X OCCUR PREMISES a occurrence $ 300000 <br /> MED EXP Wy orre person) $ 10000 <br /> A N N 35171729 D613012018 06/30/2019 PERSONAL&ADV INJURY $ 1000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 3000000 <br /> POLICY X�JECT LOC PRODUCTS-COMPIOPAGG $ 3000000 <br /> OTHER $ <br /> AUTOMOBILE LIABILITY COM13INEDSING1E LI ITT $ 1000000 <br /> Ea accident <br /> X ANYAUTO BODILYINJURY(Per person) $ <br /> A AUTOS ONLY AUTOS OWNED SCHEDULE[) N N 4925065704 06/30/2018 06/30/2019 BO01LYINJURY(Per accden[) $ <br /> AUTOS <br /> HIRED NON-OWNED PROPERTY D AGE $ <br /> AUTOS ONLY AUTOS ONLY (Per acc!deni <br /> X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 2,000,000 <br /> A 7EXCESS LIAR CDMMS-MADE N N 4925065702 D613012018 06/30/2019 AGGREGATE $ 2.000.000 <br /> DE❑ I I RETENTION$ $ <br /> WORKERS CO MPEN&ATiON X STATUTE X ER <br /> ANq EMPLOYERS'LIABILITY <br /> ANY PROPRIETORPARTNEWEXECEITIVE Y f N E.L.EACH ACCIDENT $ 1000000 <br /> A OFFICER,1MEMBER EXCLUOED7 NIA N 35148890 0613012018 06/30/2019 <br /> (Mandatoryin NH) E.L.DISEASE-EA EMPLOYE $ 1000000 <br /> Iryes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1000000 <br /> ❑ESCRIPTION OF OPERATIONS+LOCATIONS I VEHICLES IA CORD 101,Additional Remarks Schedule.may be attached if more space Is requiredI <br /> Projects: 200 S Cameron St Hillsborough NC 27278/131 W.Margaret Lane Hillsborough NC 27278 and 105 W Corbin St. Hillsborough NC 27278 <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 /> Orange County Asset Management ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Attn Tammy Comar <br /> 131 W Margaret Lane AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> Fax: Email, Q 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACOR❑ <br />