Orange County NC Website
FULLCA <br /> DocuSign Envelope ID:81 E05E8E-EED7-43D3-8B8A-0811 OE72140A <br /> DD/YY <br /> ULKTiFIGATE of LIABILITY INSURANCE FDAof/2a/TE(MM/DDNYYY) <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 riot confer ri hts to the certificate holder in lieu of such endorsements. <br /> PRODUCER 919-848-8405 .cT N.Dale Rimmer <br /> Rim mer&Assoclates,Raleigh NAMPHONE 919-848-8405 FAX 919-848-9029 <br /> 8320 Falls of Neuse Rd Ste 105 _(AICy xu Fxs: ( Ic Nv <br /> Raleigh,INC 27615 <br /> N.Date Rimmer <br /> INSURE R 1 9 <br /> INSURFRA liberty Mutual Insurance 23043 <br /> INSURED INSURER B: <br /> Full Circle Environmental LLC <br /> 107 Lee Ct INSURER C: <br /> Clayton,INC 27520 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> CQVERAGES CERTIFICATE NUMBER: I I 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 /> ILTR HSR TYPE OF INSURANCE ADDL SUB 7 Q�POLICY NUMBER POUCY P LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY CHccuRREN 1,000,000 <br /> CLAIMS-MADE OCCUR BKS60922774 03/02/2021 03/02/2022 MMfAGE,TO-{ER NrEll m01 500,000 <br /> FAED�A�one person S 15,000 <br /> PERSONAL&ADV IN U I 1,0G0+000 <br /> GENLAGGREGATE LIMITAPPLIJ S PER: GENERAL& GA 3,000,000 <br /> ROTHER: <br /> POLICY jeT LOC R�AUCTS•CQN�IOP ACiG 3r000r000 <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> E�eocl <br /> ANY AUTO 8DOHILY I14 URY(Far R2raonl <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS pp L INJURY Par accident <br /> AUTOS ONLY AA ON Y Oa£R Y AtJ1AGE a <br /> A X UMBRELLA LIAB OCCUR 1,000,000 <br /> F1 QC CURREN E <br /> EXCESS LIAR CLAIMS-MADE US060922774 03/02/2021 03/02/2022 A EGATE 1,000,000 <br /> DED I X I RETENTIONS 10,000 <br /> A AND EMPLOYERS'COMPENSATION <br /> A TIOI N X PER T}I- <br /> ANYPROPRIETORMARTNERIEXECUTIVE YIN XW559639573 03/25/2021 03/25/2022 CH ACCIDENT 1,000,000 <br /> OFFICE RIM <br /> EMI%REXCLUDED? N/A 1,000,000 <br /> andetory n I E_L.DISEASE-EA EMPLOYEE 5 <br /> If s,describe under <br /> RIPTI F I N below DISEASE-POLICY LIMIT 1 1,000,000 <br /> A Bus Personal Prop BKS60922774 03/02/2021 03/02/2022 BPP 60,000 <br /> SPECIAL FORMS REPL COST Ded 1,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> CERTIFICATE ROWER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Oran a County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g ty NC ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P.O. Box 8181 <br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE <br /> . 44S/ <br /> G <br /> ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />