Orange County NC Website
CERTIFICATE OF LIABILITY INSURANCE =10/4/2019 <br /> M/DD/YYYY) <br /> A� 5/ l /2020 <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 /> CONTACT <br /> PRODUCER L.ockton Companies NAME : <br /> 1185 Avenue of the Americas , Suite 2010 PHONE FAX <br /> A/C No Ext : A/C No) : <br /> New York NY 10036 E-MAIL <br /> 646-572-7300 ADDRESS : <br /> INSURER(S) AFFORDING COVERAGE NAIC # <br /> INSURER A : Federal Insurance Compoy 20281 <br /> INSURED Mobile Communications America, Inc . INSURER B : Chubb Indemnity Insurance Company 12777 <br /> 1462914 330 Madison Avenue, 27th Floor INSURER C : <br /> New York NY 10017 INSURER D : <br /> INSURER E : <br /> INSURER F : <br /> COVERAGES 1st NI CERTIFICATE NUMBER . 16346990 REVISION NUMBER. XxxxxXX <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 ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR SD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY <br /> A X COMMERCIAL GENERAL LIABILITY Y N 36044643 5/ 15/2019 5/ l /2020 EACH OCCURRENCE $ 1 000 000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMISES Ea occurrence $ 1 MONO <br /> MED EXP (Any one person) $ 10 ON <br /> PERSONAL & ADV INJURY $ 1 , 000 , 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 210005000 <br /> POLICY PECOT- LOC PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY Y N 9949-94-44 5/ 15/2019 5/ l /2020 COMBINED SINGLE LIMIT $ <br /> Ea accident 1 000 000 <br /> X ANY AUTO BODILY INJURY (Per person ) $ XXXX� �X <br /> OWNED SCHEDULED BODILY INJURY ( Per accident) $ XX� �XX <br /> AUTOS ONLY AUTOS $ XXXX� �X <br /> X HIRED X NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ XXXXXXX <br /> A X UMBRELLA LIAB X OCCUR Y N 7989 -39-75 5/ 15/2019 5/ l /2020 EACH OCCURRENCE $ 2500 , 000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 25 , 000 , 000 <br /> DED RETENTION $ $ XXX��XXX <br /> WORKERS COMPENSATION NX STATUTE ER <br /> B AND EMPLOYERS' LIABILITY Y / N 7175 - 1 &30 5/ 15/2019 5/ l /2020 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E. L. EACH ACCIDENT $ 1001000 <br /> OFFICER/MEMBER EXCLUDED? N N / A <br /> (Mandatory in NH) E. L. DISEASE - EA EMPLOYEE $ 1 1000 000 <br /> If yes, describe under <br /> DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ 1 , 000n000 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schfadule, may be attached if more space is required) <br /> Orange County is included as additional insured as required by written contract. <br /> CERTIFICATE HOLDER CANCELLATION See Attachment <br /> 16346990 <br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 510 Meadowlands Drive THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Hillsborough NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS . <br /> AUTHORIZED REPRE% iiE7 T ` E / <br /> © 1 88 -2015 ACORD CORPORATION . All rights reserved . <br /> ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />