Orange County NC Website
Browse       Search
DocuSign Envelope ID:05AC53B6-D6A8-4C58-AE61-C861C28D8998 <br /> �18 Erie CERTIFICATE OF INSURANCE DATE ISSUED(MM/DD/YY) <br /> 1 nsuranaf —THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY— 2/13/21 <br /> Home Office • 100 Erie Insurance Place • Erie,Pennsylvania 16530 • 814,870.2000 <br /> Toll free 1,800,458.0811 • Fax 814.870.3126 • www.erieinsurance.com <br /> NAME AND ADDRESS OF AGENCY THE BALLARD AGENCY AGENT'S NO. �' " " <br /> 105 W KING ST <br /> 3J 1010 I I A P N <br /> HILLSBOROUGH,NC 27278-2545 Co.:E EPIE INSURANC e Indemnity EXCHANGE, (NotApplicable <br /> n o. Attorne -In-Fact`` inNI <br /> (919)732-2158 This certificate is issued for information purposes only and confers <br /> NAME AND ADDRESS OF NAMED INSURED no rights on the certificate holder. It does not affirmatively or <br /> negatively amend,extend,or otherwise alter the terms,exclusions <br /> HILLSBOROUGH ARTS COUNCIL and conditions of insurance coverage contained in the policy(ies) <br /> 102 N.CHURTON ST. indicated below.The terms and conditions of the policy(ies)govern <br /> the insurance coverage as applied to any given situation.Limits <br /> HILLSBOROUGH,NC 27278 shown may have been reduced by claims paid.This certificate of <br /> insurance does not constitute a contract between the issuing <br /> insurer(s), authorized representative or producer and the <br /> certificate holder. <br /> This is to certify that policies,as indicated by the Policy Number below,are in force for the Named Insured at the time that the Certificate is being issued. <br /> c0 dd'I TYptOFINSURANCE 2,V141. POLICYNUMBER tw LIMITS' y <br /> E ®GENERAL LIABILITY1,000,000 <br /> Q32 1000580 8/10/20 8/10/21 EACH OCCURRENCE 1 000 000 %q <br /> ❑X COMMERCIAL GENERAL LIABILITY FIREDAMAGE(Ary One fire 1,000,000 <br /> ❑ ©OCCUR5,000 \\ /CLAIMS MADE <br /> MEDfXP An One Person <br /> Ac2®r, <br /> ❑ PERSONAL&A01 "INJURY 1,000 000 <br /> ❑ GENERALAG GATE 2,000 000 ' <br /> GEN'LAGGREGATE LIMIT APPLIES PER: <br /> PRODUCTS COMP/OPAGG 2,000,000 <br /> ` <br /> ®POLICY ❑PROJECT ❑LOC <br /> ❑ AUTOMOBILE LIABILITY 7ESOD(LYINJURY <br /> "ANYAUTO" <br /> (OWNED HIRED, (EACH PERSON) $ ,V. <br /> ❑ <br /> NON-OWNED) ;B DILYINJURY �' <br /> ❑OWNED <br /> EACHACCIDEN $ ". . <br /> ❑HIRED "PRU DAMAGE-, '$ <br /> ❑ NON-OWNED BODILY-INJURYAND ;, <br /> ❑GARAGE PROPERTY DAMAGEZ� <br /> nCOMBINED $ <br /> ❑EXCESS LIABILITY EACH OCCURRENCE $ � r <br /> ❑OCCURRENCE AGGREGATE $ <br /> $ 0111 <br /> ❑ RETENTION $ %k" '$ ' <br /> E WORKERS COMPENSATION& <br /> EMPLOYERS LIABILITY Q85 1800607 1/18/21 1/18/22 BODILY ACCIDENT $ 500,000 EACH ACCIDENT *" <br /> INJURY DISEASE $ 500,000 POLICY LIMIT <br /> BY DISEASE $ 500,000 EACH EMPLOYEE <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIV- <br /> ERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the <br /> terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer <br /> rights to the certificate holder in lieu of such endorsement(s). <br /> NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> Orange County AUTHO ED REPRESENTATIVE <br /> PO Box 8181 Hillborough,NC 27278 <br /> EIG6230 8/11 <br /> Page 1 of 1 <br />