Orange County NC Website
DocuSign Envelope ID: FE1 E8B92-9595-4C5D-B35A-2BA611765673 <br /> DATE(MMJDD1YYYYI <br /> A`"RV CERTIFICATE OF LIABILITY INSURANCE <br /> 1 210412 0 1 7 <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Lauren Harmond <br /> Norfleet Solutions Inc. PHONE,Ext1 770-904-5274 a Net: 678-534-6358 <br /> 4485 Tench Road E-MAIL SS: HARM01@nationwide.eom <br /> Suite 330 _ INSURER(5)AFFORDING___ _ COVERAGE _ NAIC p <br /> Suwanee,GA 30024 INSURER A: The Hartford <br /> INSURED INSURER e: United States Liability Insurance <br /> Business Oriented Software Solutions,Inc. INSURER C: <br /> 350 Research Court INSURER D: <br /> Suite 110 INSURER E: 1 <br /> Norcross,GA 30092 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. NOTWTHSTANDING 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 /> INSRT TYPE OF INSURANCE AD17L"SU BR POLICY EFF POLICY EXP OMITS <br /> LTR POLICY NUMBER MWDDIYYYY MM1DDffYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 <br /> DAMAGE TO RENTED 1,000,000 <br /> CLAIMS-MADE �//\ OCCUR PREMISES LEa_oacurrenW $__ _ _ _ <br /> - MFO FXP(Any one person) S 10,000 <br /> A I X X 33 SBA UN5608 09101/2017 09/01/2018 PERSONAL&ADV INJURY S 1,000.000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE S 2,000,000 <br /> POLICY f I PRO- <br /> POLICY JECT �. I LOC PRODUCTS-COMPlOPAGG 5 2,004,000 <br /> OTHER. -- — -- _--—_ S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1 000,000 <br /> _ PEa accidentl <br /> ANY AUTO BODILY INJURY(Per person) 5 <br /> A ALL OWNED '. SCHEDULED X X 33 SBA UN5608 09/01/2017 0910112018 BODILY INJURY(Per accident) 5 <br /> AJTOS AUTOS <br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE 5 <br /> AUTOS per accident] _ <br /> 5 <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE S <br /> EXCESS UAB _-CLAIMS-MADE AGGREGATE 5 <br /> DED RETENTIONS S <br /> WORKERS COMPENSATION X PER OTH- <br /> AND EMPLOYERS'LIABILITY , STATUTE -,_ER . <br /> A ANY PROPR[ETORIPARTNEPJEXECUTIVE Y f N E.L EACH ACCIDENT 5 1.000.000 <br /> OFFICERfMSMBEP EXCLUDED? �Y NIA X 33 WEC CD6554 0612912D17 06/29/2018 - <br /> (MandatoryinNH) _ EL_,_DISEASE-EA EMPLOYEE 5 1,000-000 <br /> If yes,describe under 1,000,000 <br /> CESCRIPTION OF OPERATIONS below P.L DISEASE-POLICY LIMIT S <br /> Professional Liability Insurance $2,000,000 Each Claim Limit <br /> B Cyber Coverage TK 1552097 0910112017 09/01/2018 $2,000,000 Annual Aggregate <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 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 EXPIRATIQN DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County Information Technoiogies ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 131 West Margaret Lane <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough, NC 29278 <br /> 0 <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />