2019-625-E AMS - Fire Brand Cedar Grove fire door inspection

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DocuSign Envelope ID:C244DA8B-F5FA-452D-96CC-93C13A7F4498 78/19/2019 E(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Telcom Insurance Services Corp. NAME: Telcom Insurance Services Corp. 6301 Ivy Lane, Suite 506 PHONE No Ext: 800.222.4664 FAX No): 301.474.6196 Greenbelt, MD 20770 E-MAIL ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# www.TelcominsGrp.com INSURER A: Twin City Fire Insurance Company 29459 INSURED INSURER B: Firebrand Pro LLC 3349 Winston Dr. INSURERC: Burlington NC 27215 INSURERD: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 50646278 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP D LIMITS LTR IN WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A `/ COMMERCIAL GENERAL LIABILITY 42SBMBC3123 7/9/2019 7/9/2020 EACH OCCURRENCE $$1,000,000 DAMAGE TO RENTED CLAIMS-MADE �✓ OCCUR PREMISES(Ea occurrence) $$1,000,000 MED EXP(Any one person) $$10,000 PERSONAL&ADV INJURY $$1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $$2,000,000 ✓ POLICY PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $$2,000,000 OTHER: $ A AUTOMOBILE LIABILITY 42SBMBC3123 7/9/2019 7/9/2020 EaacID cident81NGLELIMIT $$1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ ✓ AUTOS ONLY ✓ AUTOS ONLY Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Orange Count Asset Management Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 660 Hwy 86 North ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough NC 27278 AUTHORIZED REPRESENTATIVE Peter J.Elliott ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 50646278 1 2019 certificate I Theresa Punsalan 1 8/19/2019 4:47:51 PM (EDT) I Page 1 of 1