Orange County NC Website
DocuSign Envelope ID: F202BA43-FFBB-479D-A3DC-3F53200045DB <br /> ACCORD® CERTIFICATE OF LIABILITY INSURANCE DATE{MMriaDYYVY) <br /> `� 08/21/2019 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERriFiCATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED B Y THE POLICIES BELOW. <br /> THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE <br /> OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provi ions 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 <br /> on this certificate does not confer ri hts to the certificate holder in lieu of such endorsements . <br /> PRODUCER CONTACT <br /> NAME: <br /> AROUND THE CORNER INS PHONE FAX <br /> 4 31 BROAD ST A/C,No,Ext: AIC, o <br /> E-MAIL <br /> ADDRESS: <br /> DURHAM NC 27705 <br /> 6-7 HB INSURER(S)AFFORDING COVERAGE NAIL# <br /> INSURERA:TRAVELERS PROPERTY CASUALTY COMPANf OF AYERICA <br /> INSURED <br /> INSURER 6: <br /> GCNZALEZ PAINTERS AND INSURERC <br /> CONTRACTORS INC <br /> 4301 BENNETT MEMORIAL RD INSURERD: <br /> DURHAM NC 27705 INSURERS <br /> INSURER F, <br /> COVERAGES CERTIFICATE NUMBER: REVISION I UMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA AED ABOVE FOR THE <br /> POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT <br /> WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES <br /> DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMIT SHOWN MAY HAVE <br /> BEEN REDUCED BY PAID CLAIMS. <br /> INSA ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICYNUMBER MMIDDIYYYY MMIDDlYYYYPDAMAGE <br /> LIMITS <br /> COMMERCIAL GENERAL LIABILITY RENCE $ <br /> RENTED <br /> CLAIMS-MADE ❑OCCUR a occurrence S <br /> one arson $ <br /> ADVINJURY <br /> GEN`RLEAGpGREGATE LIMIT APPU ES PER: GENERAL $ <br /> PO�ICo PROJECT LOG PRODUCTS COMPIOP AGG $ <br /> AUTOMOBILE LIABILITY COMBINED 8 INGLE LIMIT <br /> Ea accident $ <br /> ANY AUTO BODILY INJU Y Per erson $ <br /> OWNEOAUTO$ SCHEDULED BODILYINJU Y Feraccident $ <br /> ONLY AUTOS PROPERTY AMAGE <br /> HIRED AUTOS NON-OWNED Per accident $ <br /> ONLY AUTOS ONLY <br /> 5 <br /> UMBRELLA LIAB OCCUR EACH OCCU kRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION $ <br /> WORKERS COMPENSATION PER OTH- <br /> A AND EMPLOYERS'LIABILITY (15 UB-9F56581-2-19) 03-18-19 03-18-20 X STq 'TE ER <br /> ANY PROPRIETORIPARTNERIEXECJTIVE <br /> OFFICERIMEMBER EXCLUDED7 YIN E.L.EACH A CIDENT $ 1 r 0 fl 0,00 0 <br /> (Mandatory in NH) Y NIA N <br /> E.L.DISEAS —EA EMPLOYEE$ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below 1E.L.OISEAS -POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES(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 C ANCELLED BEFORE THE <br /> EXPIRATtON DATE THEREOF,NOTICE WILL BE DELIVERS IN ACCORDANCE WITH THE <br /> POLICY PROVISIONS. <br /> ORANGE COUNTY AUTHORIZED REPRESENTATIVE <br /> PO BOX 8181 <br /> HILLSBOROUGH NC 27278 <br /> ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> (Rev.09-1 S) <br />