Orange County NC Website
DocuSign Envelope ID: D44B85EO-6EFC-4E75-B499-1B3856DB3A1A FIRST-1 OP ID: ML <br /> ,4Ca�o CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 07/24/2019 <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 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 919-383-0442 CONTACT <br /> Insurance People of INCNAME: <br /> P.O. Box 3006 p IAHICC,N o,Ext):919-383-0442 (AIC No):AX 919-382-3378 <br /> Durham,INC 27715 E-MAIL <br /> Michelle R Long,CIC,CISR ADDRESS: <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A:Philadelphia Ins Companies 18058 <br /> INSURED INSURER B:The Hartford 29424 <br /> First Securityy Service,Inc <br /> PO Box 61779 INSURER C: <br /> Durham, NC 27715-1779 <br /> 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 TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTRD WVD MM DD YYY MM <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE � OCCUR PHPK1945674 03/01/2019 03/01/2020 DAM a AGE To <br /> 100,000 <br /> PREMISES E occurrence $ <br /> MED EXP(Any oneperson) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY PECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: <br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 <br /> Ea accident $ <br /> X ANY AUTO PHPK1945674 03/01/2019 03/01/2020 BODILY INJURY Perperson) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $ <br /> HIRED NON-OWNED Per PROPERTY $ <br /> AUTOS ONLY AUTOS ONLY <br /> L r $ <br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 <br /> _4 EXCESS LIAB CLAIMS-MADE PHUB665642 03/01/2019 03/01/2020 AGGREGATE $ 4,000,000 <br /> DED X RETENTION$ 10,000 <br /> B WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> 22WBCLI2883 01/01/2019 01/01/2020 500,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Al N f A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ SOO,000 <br /> If yes,describe under 500,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE1 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange Count Waste THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g Y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Management <br /> PO Box 17177 <br /> Chapel Hill, NC 27516 AUTHORIZED REPRESENTATIVE <br /> Michelle R Long, CIC, CISR <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />