Orange County NC Website
INDEX OF FORMS ATTACHED TO THE POLICY <br />POLICY NUMBER: 2020-35634 <br />Voices TogetherNAME OF INSURED:Page: 2 <br />LIABILITY FORMS AND ENDORSEMENTS FORM NUMBER / EDITION DATE <br />Liquor Liability Coverage Form CG 00 33 04 13 <br />Additional Insured - Owners, Lessees or Contractors CG 20 10 04 13 <br />Additional Insured - State or Political Subdivisions - Permits CG 20 12 04 13 <br />Additional Insured - Mortgagee, Assignee or Receiver CG 20 18 04 13 <br />Additional Insured - Charitable Institutions CG 20 20 11 85 <br />Additional Insured - Volunteers CG 20 21 07 98 <br />Additional Insured - Designated Person or Organization CG 20 26 04 13 <br />Additional Insured - Lessor of Leased Equipment - Automatic Status - Lease CG 20 34 04 13 <br />Additional Insured - Owners, Lessees or Contractors - Completed Operations CG 20 37 04 13 <br />Exclusion - Unmanned Aircraft CG 21 09 06 15 <br />Employment-Related Practices Exclusion CG 21 47 12 07 <br />Exclusion of Certified Acts of Terrorism CG 21 73 01 15 <br />Silica - Exclusion CG 21 96 03 05 <br />Products/Completed Operations Hazard Redefined CG 24 07 01 96 <br />Common Policy Conditions IL 00 17 11 98 <br />Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 00 21 09 08 <br />North Carolina Changes - Cancellation and Nonrenewal IL 02 69 09 08 <br />Business Auto Coverage Schedule SCHEDULE BA 01 80 <br />Commercial General Liability Class Code Schedule SCHEDULE G 01 80 <br />Commercial General Liability Location Schedule SCHEDULE L 01 80 <br />This list of forms is not part of the actual policy, but is for your information only. <br />Please refer to the policy(s) for actual limits, coverages and exclusions. <br />DocuSign Envelope ID: 81A61471-345A-47F9-8A2D-36F7929A6637