Orange County NC Website
Browse       Search
DocuSign Envelope ID:05AC53B6-D6A8-4C58-AE61-C861C28D8998 <br /> .4c' Ro v� CERTIFICATE 4F LIABILITY INSURANCE F3/2 <br /> "2/ M/pDIYYYY) <br /> 020 <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. II SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy,certain Policies may require an endorsement. A statement on ttris certificate does not carfer rights to the <br /> certificate hostler in lieu of such endmarrient(s). <br /> !PROULCERCOVrACT <br /> j BALLARD AGENCY INC t"E: J. David Ballard <br /> PHONE 919 732-2158 <br /> PO Box 1559 AlcNo (919)732-9636 <br /> j Hillsborough, NC 2727$ <br /> ADDRESS balIard@ba11arda enc inc.com <br /> 1NSUPER(S) AFFORDING COVERAGE NAMI <br /> INSURER A,GREAT AMERICAN INSURANCE CO.A <br /> IVSUHED HILLSBOROUGH ARTS COUNCIL <br /> INSURER B <br /> PO SOX 625 INSURER C <br /> HILLSBOROUGH, NC 27278 INSURER0 <br /> 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 COND17ION 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 /> INaR <br /> G <br /> LTR TYPE OF INSURANCE I DOS VrVD <br /> POLJCY NUMBER MM1oDM'YY M bfVYYv LIMITS <br /> COMMERCIAL GENERAL LIAerLlll' <br /> EACH OCCURRENCE t <br /> CLAIMS-MADE OCCUR PREMISES Me occurrencB S <br /> �GENERAL <br /> I]EXP(Any one person)RSONAL&ADV INJUPY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER�IPRO- AGGREGATE g <br /> POLICY U JECT LOC PRODUCTS-COMPJOP A(3G 5 <br /> OTHER <br /> AUTOMOBILE UASILITY <br /> Ee accidonl $ <br /> ANVAUTO j BODILY INJURY(Per person) s <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS BODILY INJURY(Peracadent) & <br /> HIRED AU'r45 NON-OWNED <br /> AUTOS PROPERTY <br /> Per accident) $ <br /> UMBRELLA UAB OCCURS <br /> EACH OCCURRENCE $ <br /> EXCESS L1AB CLAIMS-MADE <br /> AGGREGATE $ <br /> DIEDRETENTION$ <br /> WORKERS COMPENSATION $ <br /> AND EMPLCYERS'LIABILITY v;u STATUTE ER <br /> ANv "P0PRETOR/PARTNER1EXECIITIVE $ <br /> OFFICERWEMBER FXrLU1DE07 NIA E.L EACHACCIDEN7 <br /> (Uendldory In NH) ❑ <br /> IryyeOS5 describe under E,L DISEASE-EA EMPLOYE 5 <br /> OESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT s <br /> $1,000,000 OCC WRONGFULL <br /> A DIRECTOR & OFFICERS EPP4917790 1/16/201/16/21ACTS $1 ,000,000 OCC <br /> LIABILITY EMPLOYMENT PRACTICES <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS i VEHICLES (ACORD 101.Additional Rerrft Schedule,maybe attwhed N-ore space Is required) <br /> $1,000,000 AGGREGATE LIMIT <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> HILLSBOROUGH, NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORI D REPRESENTATIVE <br /> .' <br /> OO 1988-2014 ACORD CORPORATION, All rights reserved. <br /> ACORD25(2414101) The ACORD name and logo are regi r d marks of ACORD <br />