Orange County NC Website
Browse       Search
DocuSign Envelope ID:658A459F-A778-460E-9BE2-7EF08EAF03B2 <br /> BORDCON-02 MAIRINGTON <br /> FDATE fMMIDDIYYYYI <br /> CERTIFICATE OF LIABILITY INSURANCE 12/18/2019 <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 CONTACT Melanie A.Airington <br /> Trisure,an Alera Group Company ADCO"N,EIt:(919)4 6 9-2 4 7 3 1 f,Nn:(919)467-4987 <br /> 4325 Lake Boone Trail,Suite 200 EMAIL <br /> Raleigh,NC 27607 DD •mairington_@trisure.com <br /> INSURERS AFFORDING COVERAGE NAIC N <br /> INSURER A:Charter Oak Fire Insurance Company The 25615 <br /> INSURED INSURER B:Travelers Property C_asuakt Company of America 25674 <br /> Bordeaux Construction Company,Inc. INSURER C:Phoenix Insurance Company The 25623 <br /> #101 - <br /> 135 E Martin St INSURER D:Tokio Marine Special 23850 <br /> Raleigh,NC 27601 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 /> INSR TYPE OF INSURANCE ADDL SUER INSD VIVO POLICY NUMBER POLICY EFF POLICY EXPLTR MMIDDIY LIMITS <br /> A x COMMERCIAL GENERAL LIABILITY 1,000,000 <br /> EACH OCCURRENCE <br /> CLAIMS-MADE �OCCUR x COZF979366 12/31/2019 12131/2020 DAMoccurrence)P AGE Tp RENTE❑ $ 300,000 <br /> x Contractual Liab ME EXP(Any oneperson) $ 10,000 <br /> PERSONAL 8 ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY ]CEO LOC PRODUCTS-COMPIOPAGG $ 2,000,000 <br /> OTHER: <br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> X ANY AUTO 81021-173833 12/31/2019 12/31/2020 BODILY INJURY Perperson) $ <br /> OMED X SCHEDULED <br /> AIUgqTEEO��S ONLY AUTOS <br /> SSyyryEp -BODILY INJURY Per accident $ <br /> x AUTOS ONLY X ONO MN Perpacc tlenEAMAGE $ <br /> x Comp$500 1 X Call$500 <br /> B X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 10,000,000 <br /> EXCESS LIAR CLAIMS-MADE CUP4KOO9166 12/31/2019 121311202D AGGREGATE $ 10,000,000 <br /> DED I x I RETENTION$ 10,000 <br /> C WORKERS COMPENSATION X PER DTH- <br /> AND EMPLOYERS'LIABILITY YIN UB8J493303 12/31/20 9 12/31/2020 STATUTE 1,000,000 <br /> ANY PROPRIETORIPARTNERIEXECUTIVE NIA E,I.EACH ACCIDENT $ <br /> OFFICERIMEMHER EXCLUDED? <br /> fMandalory n I E-L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> IF vas-describe udder 1,000,040 <br /> DESCRIPTION OF OPERATIONS below E-L.DISEASE-POLICY LIMIT <br /> D Profession/Pollution PPK1954292 3/12/2019 3/12/2020 Limit 5,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES `ACORD 101.Additional Remarks Schedule,may be attached If mores ace Is required] <br /> Leased/Rented Equipment 66D7F242185(Title Charter Oak Fire Insurance Go.)NAIC#2 561 5 1 2131119-1 2�31/20 LeasedlRented Equipment Limit $150.000 <br /> Operations of the Named Insured covered by the above referenced policies. <br /> Orange County Is listed as additonal insured with respect to General Liability. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange Count THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO BOX 8181 <br /> Hillsborough,INC 27278 <br /> AUTHORIZED REPRESENTATIVE <br /> pw� <br /> ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />