Orange County NC Website
DocuSign Envelope ID:4EEOODB3-58ED-4043-B994-CC4D4896F2FE <br /> ® 7c9/18/201 <br /> E(MMIDDIYYYY) <br /> AC"REP <br /> CERTIFICATE OF LIABILITY INSURANCE 9 <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{iesy 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 Carla Moore <br /> NAME: <br /> Colonial Insurance Agency Hillsborough A'ON111.'E 919 73P-P191 AAA No I: 919 732-P192 <br /> AAOC'RILS , carlaCc)colonial-a en .CDm <br /> Po Bar 490 INSURERS AFFORDING COVERAGE NAn# <br /> Hillsborough NC 27278 iNSURERA: 04,mers I ns CO 32700 <br /> INSURED INSURER B <br /> Greer and Associates Inc dba Signarama INSURER C <br /> Raleigh West-RTP and of Durham.Design Element of NC INSURER D: <br /> 3702 Hillsborcigh Rd Ste 1 INSURER E: <br /> Durham NC 27705 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 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 /> 1NSR TYPE OF INSURANCE AODL SUBR POLICY NUMBER POLCY EFF POLICY <br /> LTR LIMEYS <br /> X COMMERCIAL GENERAL LUIBILITY EACH OCCURRENCE $ 1000000 <br /> CLAIMS-MADE FX7 OCCUR PREMISES a occurrence $ 300000 <br /> MED EXP(Any orre person) $ 10000 <br /> A N N 35171729 06/80/2019 0613O/2020 PERSONAL a ACV INJURY $ 1000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3000000 <br /> POLICY 191 PRO JECT LOC PRODUCTS-COMPMPAGG $ 3000000 <br /> OTHER $ <br /> AUTOMOBILE LIABILITY COM8IN.DSINGLE LIMIT <br /> Eaa cc�denl <br /> $ 1000000 <br /> X ANY AUTO BODILY VJURY(Per person) $ <br /> A AUTOS ONLY AUTOS OWNED AUTOS SCHEDULED N N 4925065704 06/30/2019 06/30/2020 BODILY INJURY(Per accdeng $ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ <br /> X UMBRELLA LIAS X OCCUR EACH OCCURRENCE $ 2.000.000 <br /> APo <br /> XCESS LIAR CLAIMS-MADE N N 4925065702 06/302019 06/302020 AGGREGATE $ 2.000.000 <br /> ED RETENTION $ <br /> WORKERS COMPENSATION STATUTE X ER <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROP RIETOR:PARTTIERIEXEC[ITIVE YIN E.L-EACH ACCIDENT $ 10DODOO <br /> A OFFICERr41EMBER EXCLUDED? F 7N NIA N 35148890 06/30/2019 06MO2020 <br /> IMendatoryIn NH) E.L.DISEASE-EA EMPLOYE E $ 1000000 <br /> II yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMn $ 1000000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES IA CORD 101,Additional Remarks Schedule,may be attached If more apace IS requiredI <br /> Projects: 103 Meadowlands Drive Hillsborough NC 27278 <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 /> PC BLOC 8181 AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> Fax: Email: D 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />