Orange County NC Website
DocuSign Envelope ID:AF8C0098-E41 E-4A92-BEA6-388EE5DF4E16 <br /> D® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD <br /> 08/21/2012D19 <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 E Y THE POLICIES BELOW. <br /> THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREII AUTH RIZED REPRESENTATIVE <br /> OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provi ions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endor ement. A statement <br /> on this certificate does not confer rights to the certificate holder in lieu of such endorsements . <br /> PRODUCER CONTACT <br /> NAME, <br /> AROUND THE CORNER INS PHONE Pax <br /> 1431 BROAD ST A1C,No,Ext: AlC, o <br /> E-MAIL <br /> ADDRESS: <br /> DURHAM NC 27705 <br /> 7�?H)3 INSURER(S)AFFORDING COVERAGE NAIL p <br /> INSURER A:TRAVELERS PROPERTY CASUALTY COMPAN OF ANERICA <br /> INSURED <br /> iNSl1RER B: <br /> GONZALEZ PAINTERS AND INSURER C: <br /> CONTRACTORS INC <br /> 4301 BENNETT MEMORIAL RD INSURERD: <br /> DURHAM NC 27705 INSURERF <br /> INSURER F. <br /> COVERAGES CERTIFICATE NUMBER: REVISION I UMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED N ED ABOVE FOR THE <br /> POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OTHER DOCUMENT <br /> WITH RESPECT TO WHICH THIS CERTIFICATE=. MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES <br /> DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE <br /> BEEN REDUCED BY PAID CLAIMS. <br /> INS14 ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSO WVO POLICY NUMBER MMlDDIYYYY MM1DDlYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCL ZRENCE $ <br /> DAMAGE T RENTED <br /> CLAIMS-MADE ❑OCCUR PREMISES a occurrence $ <br /> MED EXP Y one arson $ <br /> PERSONAL ADV INJURY <br /> GEN'RL EAGGgGREGATE LIMIT APPLIES PER: GENERAL $ <br /> POLIO PROJECT ❑ LOC PRODUCTS COMPIOP AGG $ <br /> $ <br /> AUTOMOBILE LIABILITY COMBINED E INGLE LIMIT <br /> Ea accident $ <br /> ANY AUTO BODILY INJU iY Perperson) $ <br /> OWNEDAUTOS SCHEDULED BODILYINJU Y Per accident $ <br /> ONLY AUTOS PROPERTY AMAGE <br /> HIRED AUTOS NON-OWNED Per accident $ <br /> ONLY AUTOS ONLY <br /> 5 <br /> UMBRELLA LIAR OCCUR EACH OCCU kRENCE $ <br /> EXCESS UAS CLAIMS-MADE AGGREGATE $ <br /> DEDI IRETENTION $ <br /> WORKERS COMPENSATION EA OH A AND EMPLOYERS'LIABILITY (6JUB-9F56581-2-19) 03-18-19 03-18-20 X S TE R <br /> ANY PROPRiFTORIPARTNERIEXECUTIVE <br /> OFFICERWEMBER EXCLUDED? YIN E.L.EACH A CIDENT 5 1,000,000 <br /> (Mandatory in NH) 1r N <br /> N!p' E.L.DISEAS —EA EMPLOYEE$ 1,000,0O0 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE —POLICY LIMIT S 1,000,000 <br /> DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES(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 C ANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERS IN ACCORDANCE WITH THE <br /> POLICY PROVISIONS. <br /> ORANGE COUNTY AUTHORIZED REPRESENTATIVE <br /> PO BOX 8181 <br /> HILLSBOROUGH NC 27278 <br /> ©1988-2015 ACORD CORPORATION,All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> (Rev.09-18) <br />