Orange County NC Website
DocuSign Envelope ID:9A4D309B-6AAB-44AA-9D5E-839E5DD918EF <br /> �1 WATEINV-01 PARKER <br /> (MMAVDrYYYYj CERTIFICATE OF LIABILITY INSURANCE <br /> 411319,io <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 0n <br /> this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). <br /> PRODUCER lAcT Sterling S.Parker <br /> Trisure,an Alera Group Company � e,Ext; 919 469-24?3 FAX <br /> 4325 Lake Boone Trail,Suite 200 j (A/C.No,(919)467-49$7 <br /> Raleigh,NC 27607AI .sparker@trisuro.com <br /> INSU RERIS1 AFFORDING COVERAGE NAICA <br /> INSURER A:Tho Harford Mutual Insurance Company 14141 <br /> INSURED INSURER B: <br /> Watershed Investments NC,LLC INSURER C: <br /> 1630 Weatherford Circle INSURER D <br /> Raleigh,NC 27604 <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 CONTRACTOR 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 /> ILTR NSR TYPE OF INSURANCE ADOL SUBINSD DR POLICY NUMBER POLICY EFF POLICY EXIP LIMITS <br /> A x COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0()0 <br /> CLAIMS-MADE FxI OCCUR 9186735 7/1912019 7/1912020 DAMAGE Tp RENTED S 300,000 <br /> MED EXP(Any one porsonj 10,000 <br /> PERSONAL&ADV INJURY 1.000,000 <br /> GEN'LAGGREGATE UWT APPLIES PER: GENERAL AGGREGATE 2,000,000 <br /> POLICY j FX-1 LOC PRODUCTS-COMPIOPAGG 2,000,000 <br /> OTHER: <br /> S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO BODILY INJURY Per ersan S <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS <br /> 1 {e BODILY INJURY Peraccldent S <br /> AUTOS ONLY AUTO❑NLDY Per ac_dT,,, MAGE S <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR Id CLAIMS-MADE AGGREGATE <br /> DE❑ I I RETENTION 5 <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y I N <br /> ANY PROPRIETORIPARTNERIEXECUTIVE <br /> ppFFICERIMEM8ER E7[CLUDE07 ❑ NIA E.L.EACH ACCIDENT <br /> ;Marsdatory Ia NHI <br /> If pas,describe under <br /> E.L.DISEASE-EA EMPLOYEE <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101.Add itlonaI Remaiks Schedule,may be attached it more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County,Dept of Environment,Agriculture, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Parks and Recreation <br /> 306A Revere Rd Hillsborough <br /> Hillsborough,NC 27278 AUTHORIZED REP RESENTATIVE <br /> * RE <br /> ACORD 25(2016103) 01988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />