Orange County NC Website
DocuSiggn Envelope ID:7CAOFA04-48AO-4485-95B6-84D4F69C2B80 <br /> ULK i 1HUA fE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) <br /> 09/21/2020 <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 endorsement(s). <br /> PRODUCER CONTACT Larry F Hodges <br /> Ai Insurance PHOA/CN o Ext: 252-937-2816 FAX 252-937-6301 <br /> PO Box 2444 E-MAIL A/C No <br /> ADDRESS: larryhodges@aiins.us <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> FAYETTEVILLE NC 28302 Mt Hawley------- INSURER A: y Insurance Co. <br /> INSURED <br /> INSURER B: Mt Hawley Insurance CO. <br /> FIRST FIRE PROTECTION INC INSURER C: Integon Indemnity Corp. <br /> PO BOX 10594 INSURER D: Ohio Security Insurance Co. <br /> INSURER E: <br /> RALEIGH NC 27605-0594 INSURERF: <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 /> INSR ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE I POLICY NUMBER MOLIC YEFF MM/DD/YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE OCCUR DAMAGE TPREMISES I K T occurrence) $ 100,000 <br /> A X X PGA0004518 <br /> MED EXP(Any one person) $ 5,000 <br /> 09/05/2020 09/05/2021 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY JPE O- LOC <br /> PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> ANY AUTO <br /> Ea accident <br /> OWNED SCHEDULED BODILY INJURY(Per person) $ <br /> C <br /> AUTOS ONLY X AUTOS X X 2009478282 05/08/2020 05/08/2021 BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> MEDICAL PAYMENTS $ 1,000 <br /> UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 <br /> B X EXCESS LIAB CLAIMS-MADE XGA0001803 09/05/2020 09/05/2021 AGGREGATE $ 2,000,000 <br /> DIED RETENTION$ PRODUCTS COMPLETED $ 2,000,000 <br /> WORKERS COMPENSATION I PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTI VE <br /> D OFFICER/MEMBER EXCLUDED? NIA XWS60618609 11/14/2019 11/14/2020 E.L.EACH ACCIDENT $ 1,000,000 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under � , _ <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Inspection,Service/Repair and Testing of Alarm Systems,Fire Extinguishers and Smoke Detectors for Commercial Businesses. Christopher D Register,as President/CEO of <br /> First Fire Protection Inc Has Opted to be Excluded Under Workers Compensation Policy. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County, NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> PO Box 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough NC 27278-8181 AUTHORIZED REPRESENTATIVE <br /> LARRY F HODGES <br /> ©1988-2015 ACORD CORPORATION. All rights reserve <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />