Orange County NC Website
DocuSign Envelope ID:CD0026AD-BEB2-4543-AC81-1`0131129E8175 <br /> CREAT-5 OP ID7 MAT <br /> CERTIFICATE OF LIABILITY INSURANCE DATE 02I812019Y, <br /> a211 slzol� <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 endorsements . <br /> PRODUCER 919 878-9412 C NTACT Highsmith Insurance <br /> Highsmith Insurance PHONE 91 g_87g.g412 FAX 919-256-1969 <br /> a Marsh&McLennan Agency LLC AIC,No,Ext; Ale Np <br /> 3700 Glenwood Ave.,Suite 430 E 1RI .matt@highsmithinsurance.com <br /> Raleigh,NC 27612 <br /> Matthew Horney INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A:Selective Ins,Co of America 12572 <br /> INSURED INSURER B:Hartford Acc&Indemnity Co 22357 <br /> Creative Business Interiors In <br /> 8720Fleet Service Drive INSURERC: <br /> Raleigh,NC 27617 <br /> -INSURER°: <br /> INSURER E <br /> INSURER F <br /> COVERAGES CERTIFICATE NtjMI3FRo ISEVISIONNUMBER: <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 OFINSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS <br /> A x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 <br /> CLAIMS-MADE �x OCCUR S 2338296 11/27/2018 11127/2019 DAMAGE TO RENTED 50e,00e <br /> MED EXP(Any one erson 16,000 <br /> PERSONAL&ADV INJURY 1,000,000 <br /> L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 3,000,000 <br /> x POLICY ma LOC PRODUCTS-COMPIOP AGG S 3,000,000 <br /> A AUTOMOBILE LIABILk7Y COMBINED SINGLE LIMIT 1,000,000 <br /> x ANY AUTO S 2338296 11/27/2018 11/27/2019 BODILYINJURY Per son <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUUTNOSWryEp BODILY INJURY Per accident <br /> x AUTOS ONLY L <br /> Af77Q ONLY Perr,,.,J n[D�GE <br /> A X UMBRELLA LIAE x OCCUR EACH OCCURRENCE 3,000,000 <br /> EXCESS LIAR CLAIMS-MADE S 2338296 11/27/2018 11/27/2019 AGGREGATE g 3,000,000 <br /> ❑ED I I RETENTION$ <br /> 13 AND EMPLRKERSYERS'COMPENSATION A YIN 22WBCEM0470 11127/2018 11127120i9 x PER rR OTH- <br /> ANY PROPRIETORIPARTNERIEXECUIWt: E.L.EACH ACCIDENT 500,000 <br /> OFFICERIMEMBER EXCLUDED? NI NIA <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S 500,0017 <br /> It yes,describe under <br /> ❑E9CRIPTION OF OPERATIONS below E.L.DISEASE-POLICY I 500,000 <br /> A Employment Prac S 2338296-01 11/27/2018 11/27/2019 Empl Prac 100,000 <br /> A Crime S 2338296-01 11/27/2018 11/27/2019 Crime 25,000 <br /> DESCRIPTION OF OPERATIONS f LOCATIONS 1 VEHICLES (ACORD 101,Additional Romarks Schedule,may be attached If more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ❑RANGEC <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 /> PO BOX 8181 <br /> Hillsborough, NC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />