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2021-209-E-AMS-Riley Surveying-Builders first-401 Vally Forge
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2021-209-E-AMS-Riley Surveying-Builders first-401 Vally Forge
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Last modified
5/18/2021 2:45:46 PM
Creation date
5/18/2021 2:43:56 PM
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Contract
Date
4/21/2021
Contract Starting Date
4/21/2021
Contract Ending Date
4/28/2021
Contract Document Type
Contract
Amount
$8,600.00
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DocuSign Envelope ID:9E76CCCF-2564-4499-A1CA-43EC4ECE13EB <br /> A� O8/07/07® CERTIFICATE OF LIABILITY INSURANCE DATE //2020DDM ) <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 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 Jason Mingledorff <br /> NAME: <br /> Trustpoint Insurance PHONE (g66)276-9622 FAX (888)872-5496 <br /> A/C No Ext: AIC,No <br /> 16 E Church Ave E-MAIL jmingledorff@trustpointins.com <br /> ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC q <br /> Roanoke VA 24011 INSURERA: Hanover Insurance Company 22292 <br /> INSURED <br /> INSURER B <br /> Riley Surveying,P.A. INSURER C: <br /> 3326 Durham Chapel Hill Blvd INSURER D: <br /> Ste B-100 INSURER E: <br /> Durham NC 27707 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 20-22 Master 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 /> IN SR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> -F TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ <br /> J ECT <br /> POLICY PRO ❑LOC PRODUCTS-COMP/OPAGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANYAUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Par accident <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ElN/A E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Professional Liability Each Claim 2,000,000 <br /> A E&O LHR H330773 00 08/10/2020 08/10/2022 Aggregate 2,000,000 <br /> Deductible 2,500 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> certificate provided as evidence of insurance <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Orange County Asset Management Services ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 131 West Market Lane <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />
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