Orange County NC Website
DocuSign Envelope ID:48D95A50-1183-4EB9-9997-46BD3AOD7724 <br /> 9 <br /> LIA Adminlstrators & Insurance Services <br /> APPRAISAL AND VALUATION ASPEN <br /> PROFESSIONAL LIABILITY INSURANCE POLICY <br /> DECLARATIONS <br /> ASPEN AMERICAN INSURANCE COMPANY <br /> (A stock insurance company herein called the "Company") <br /> 175 Capitol Blvd. Suite 100 <br /> Rocky Hill, CT 06067 <br /> Date Issued Policy Number Previous Policy Number <br /> 07/25/2018 AA1006533-04 AA1006533-03 <br /> THIS IS A CLAIMS MADE AND REPORTED POLICY. COVERAGE IS LIMITED TO LIABILITY FOR ONLY THOSE <br /> CLAIMS THAT ARE FIRST MADE AGAINST THE INSURED DURING THE POLICY PERIOD AND THEN REPORT- <br /> ED TO THE COMPANY IN WRITING NO LATER THAN SIXTY(60)DAYS AFTER EXPIRATION OR TERMINATION <br /> OF THIS POLICY, OR DURING THE EXTENDED REPORTING PERIOD, IF APPLICABLE,FOR A WRONGFUL <br /> ACT COMMITTED ON OR AFTER THE RETROACTIVE DATE AND BEFORE THE END OF THE POLICY <br /> PERIOD. PLEASE READ THE POLICY CAREFULLY. <br /> Item <br /> 1. Customer ID: 113569 <br /> Named Insured: <br /> ANALYTICAL CONSULTANTS, INC. <br /> 125 Kingston Drive <br /> Chapel Hill,NC 27514 <br /> 2. Policy Period:' From: 09/09/2018 To: 09/09/2019 <br /> 12:01 A.M. Standard Time at the address stated in 1 above. <br /> 3. Deductible: $5,000 Each Claim <br /> 4. Retroactive Date: 09/09/2004 <br /> 5. Inception Date: 09/09/2015 <br /> 6. Limits of Liability: A. $2,000,000 Each Claim <br /> B. $2,000,000 Aggregate <br /> 7. Mail all notices, including notice of Claim, to: <br /> LIA Administrators&Insurance Services <br /> 1600 Anacapa Street <br /> Santa Barbara, California 93101 <br /> (800) 334-0652; Fax: (805)962-0652 <br /> 8.Annual Premium: <br /> 9. Forms attached at issue: LIA002 (12/14) LIA NC (02/16) LIA NC NOT(11/15) LIA012 (12/14) <br /> LIA013 (10/14) LIA020NC(02/16) LIA025A(11/14) LIA112 (10114) <br /> This Declarations Page, together with the completed and signed Policy Application including all attachments and exhibits thereto,and <br /> the Policy shall constitute the contract between the Named Insured and th o any. <br /> 07/25/2018 By c� <br /> Date Authorized Sighature <br /> LIA-001 (12/14) Aspen American Insurance Company <br />