Orange County NC Website
DocuSign Envelope ID: EFF6E9D4-D211-4AAE-8028-478C17134FBF <br /> A ��0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/11/12/2019 Y) <br /> 019 <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 CONTACT Rebekah Rosko <br /> NAME: <br /> Insurance Management Consultants,Inc. (AHCC Ext: (704)799-1600 IX No: (704)799-2955 <br /> P.O.Box 2490 E-MAIL cert@imcipls.com <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> Davidson NC 28036 INSURERA: RLI Insurance Company 13056 <br /> INSURED INSURER B: <br /> HH Architecture,PA INSURER C: <br /> 1100 Dresser Ct INSURER D: <br /> INSURER E: <br /> Raleigh NC 27609 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 19/20 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 ADDLSUBR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> DAMAGE To CLAIMS-MADE � OCCUR PREMISES Ea occurrence)l <br /> $ 1,000,000 <br /> MED EXP(Any one person) $ 10,000 <br /> A PSB0005258 07/13/2019 07/13/2020 PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 4,000,000 <br /> JECT <br /> OTHER: Hired and Non Owned $ 2,000,000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 <br /> (Ea accident) <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED PSB0005258 07/13/2019 07/13/2020 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> X HIRED �/ NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY /� AUTOS ONLY (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION $ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> YIN 1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> A OFFICER/MEMBER EXCLUDED? ❑ NIA PSW0003050 07/13/2019 07/13/2020 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Per Claim $1,000,000 <br /> A Professional Liability RDP0036875 07/13/2019 07/13/2020 Aggregate $2,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (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 CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P.O.Box 8181 <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 ��/✓� �s�� <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />