Orange County NC Website
DocuSign Envelope ID:OB401C69-A141-4378-A5B8-33AC09CDCF23 <br /> EXTRVEN-01 PARME1 <br /> ,4coR0 CERTIFICATE OF LIABILITY INSURANCE 7DATE(MMIDD/YYYY) <br /> 12/9/2020 <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 <br /> NAME: <br /> The Insurance Center of Durham PHONE FAX <br /> 1920 Front Street,Suite 710 (A/C,No,Ext): (919)471-2541 (A/C,No):(919)471-2132 <br /> Durham,INC 27705 ADDRESS: <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A:The Cincinnati Indemnity Co. 23280 <br /> INSURED INSURER B:Travelers Insurance(AWC) 36137 <br /> Extraordinary Ventures,Inc. INSURER C: <br /> Paige Morrow <br /> 200 S.Elliott Road INSURER D: <br /> Chapel Hill, INC 27514 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 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR INSD WVD MM DD YYY MM DD YYY <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE � OCCUR ETD 0382315 4/30/2020 4/30/2021 DAMAGE TO RENTED 100,000 <br /> PREMISES Ea occurrence $ <br /> MED EXP(Any oneperson) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICYEl PECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 <br /> Ea accident $ <br /> ANY AUTO ETD 0382315 4/30/2020 4/30/2021 BODILY INJURY Perperson) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $ <br /> X HIRED X NON-OWNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY Per accident $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> B WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE ER <br /> Y/N 6JUB4816P272 20 8/25/2020 8/25/2021 1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFFICER/MEMBER EXCLUDED? N I A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/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 /> Count of Orange THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Y 9 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough,INC 27278 <br /> AUTHORIZED REPRESENTATTI VE <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />