Orange County NC Website
Browse       Search
DocuSign Envelope ID:44FOD66E-1905-4A6D-B2D2-D7CO2EDF751A <br /> 4C__"" DATE(MM/DD/YYYY) <br /> lh� CERTIFICATE OF LIABILITY INSURANCE 01/22/2019 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE <br /> AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br /> ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, <br /> subject to the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does <br /> not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT NAME: <br /> PAYCHEX INSURANCE AGENCY INC/PAC <br /> 76250881 PHONE (877)287-1312 Fax (888)443-6112 <br /> (A/C,No,Ext): (A/C,No): <br /> 150 SAWGRASS DRIVE <br /> E-MAIL ADDRESS: <br /> ROCHESTER NY14620 <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA: Trumbull Insurance Company 27120 <br /> INSURED INSURER B: <br /> EL FUTURO INSURER C: <br /> 2020 CHAPEL HILL RD STE 23 <br /> DURHAM NC 27707-1186 INSURER D: <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 <br /> TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSR WVD MM/DD/YYYY MM/DD/YYYY <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE <br /> CLAIMS-MADE❑OCCUR DAMAGE TO RENTED <br /> PREMISES Ea occurrence <br /> MED EXP(Any one person) <br /> PERSONAL&ADV INJURY <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE <br /> JECT <br /> POLICY El PRO ❑LOC PRODUCTS-COMP/OP AGG <br /> OTHER: <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY(Per accident) <br /> HIRED NON-OWNED PROPERTY DAMAGE <br /> AUTOS AUTOS (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS- AGGREGATE <br /> MADE <br /> DED RETENTION$ <br /> WORKERS COMPENSATION PER X OTH- <br /> AND EMPLOYERS'LIABILITY AT <br /> ER <br /> ANY Y/N E.L.EACH ACCIDENT $1,000,000 <br /> A PROPRIETOR/PARTNER/EXECUTIVE N/A 76 WBG ZS2911 11/12/2018 11/12/2019 <br /> OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> (Mandatory in NH) <br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Those usual to the Insured's Operations. <br /> CERTIFICATE HOLDER CANCELLATION <br /> FOR INFORMATIONAL PURPOSES ONLY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> 2020 CHAPEL HILL RD STE 23 BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED <br /> DURHAM NC 27707-1186 IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />