Orange County NC Website
DocuSign Envelope ID:8FF67418-E481-498A-99FD-471 DE1 25EDF5 <br /> ACOR"° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 7/1/2021 9/23/2020 <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 LOCKTON COMPANIES NAME:ACT <br /> 2100 ROSS AVENUE,SUITE 1400 PHONE FAX <br /> AIC,No,Ext: AIC,No <br /> DALLAS TX 75201 E-MAIL <br /> 214-969-6700 ADDRESS: <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A: Mitsui Sumitomo Insurance Co of America 20362 <br /> INSURED OVERHEAD DOOR CORPORATION INSURER B: Mitsui Sumitomo Insurance USA Inc. 22551 <br /> 1342188 AND ITS SUBSIDIARIES LISTED ON THE NAMED INSURED INSURER C: Allianz Global Risks US Insurance Co 35300 <br /> SCHEDULE ATTACHED HERETO <br /> 2501 SOUTH STATE HIGHWAY 121,SUITE 200 INSURERD: <br /> LEWISVILLE TX 75067 INSURER E: <br /> INSURER F: <br /> COVERAGES ODC-USEONLY CERTIFICATE NUMBER: 13748109 REVISION NUMBER: XXXXXXX <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 INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY Y N GL 2122489 10/1/2020 10/1/2021 EACH OCCURRENCE 2,000,000 <br /> CLAIMS-MADE�OCCUR PREMISES(Ea occurrence) 1,000,000 <br /> X SIR applies per <br /> MED EXP(Any oneperson) 10,000 <br /> nolicy terms&cond. PERSONAL&ADV INJURY $ 2,000,000 <br /> GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X P ❑PRO- ❑LOC <br /> OLICY <br /> JECT PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY N N BVR 8406521 10/1/2020 10/1/2021 (Ea <br /> accidentSINGLE LIMIT $ 2,000,000 <br /> A X ANY AUTO BVR 8803088 10/1/2020 10/1/2021 BODILY INJURY(Per person) $ XXXXXXX <br /> OWNED SCHEDULED BODILY INJURY(Per accident $ XXXXXXX <br /> AUTOS ONLYM <br /> AUTOS <br /> X HIRED <br /> ONLY AUUTOS ONLYY PROPERTY <br /> $ XXXXXXX <br /> $ XXXXXXX <br /> C X UMBRELLA LIAB X OCCUR N N USLO1374720 10/1/2020 10/1/2021 EACH OCCURRENCE $ 10,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 <br /> DED I X I RETENTION$10,000 $ XXXXXXX <br /> WORKERS COMPENSATIN TI- <br /> A AND EMPLOYERS'LIABILITY YIN N WCP 9113272 10/1/2020 10/1/2021 X STATUTE OER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> If <br /> in aNH)nd E.L.DISEASE-EA EMPLOYEE 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 <br /> B Excess Workers Comp. N N XWC9800047 7/1/2020 7/1/2021 WC Statutory Limits;I EL/Ea <br /> Accident;1M EL Disease Emp/Policy <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Re:Project:Orange County Skills and Development Center,503 West Franklin Street,Chapel Hill,NC 27516. <br /> CERTIFICATE HOLDER CANCELLATION See Attachments <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 13748109 AUTHORIZED REPRESENTATIVE <br /> Orange County Asset Management Services <br /> Attn:Allison Cooper <br /> PO Box 8181 <br /> Hillsborough NC 27278 <br /> , <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION.All rights reserved <br /> The ACORD name and logo are registered marks of ACORD <br />