Orange County NC Website
Holder Identifier : 7777777707070700077763616065553330763735764015474607762215770634132071660557146323320752405333247011007340055712674310073260355324501320770661511263213007324231152270130077727252025773110777777707000707007 6666666606060600062606466204446200620220406226002006220204062060000062200040620622020602200626224002006220004242240002062222240622420020600022406022262206202066220440062066646062240664440666666606000606006Certificate No : 570088033661 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 06/24/2021 <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <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 BELOW. <br />THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />PRODUCER <br />Aon Risk Insurance Services West, Inc. <br />San Francisco CA Office <br />425 Market Street <br />Suite 2800 <br />San Francisco CA 94105 USA <br />PHONE <br />(A/C. No. Ext): <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />(415) 486-7000 <br />INSURED 19437Lexington Insurance CompanyINSURER A: <br />11150Arch Insurance CompanyINSURER B: <br />30830Arch Indemnity Insurance CompanyINSURER C: <br />27960Illinois Union Insurance CompanyINSURER D: <br />INSURER E: <br />INSURER F: <br />FAX <br />(A/C. No.):(415) 486-7029 <br />CONTACT <br />NAME: <br />AMN Healthcare, Inc. <br />12400 High Bluff Drive <br />San Diego CA 92130-3077 USA <br />COVERAGES CERTIFICATE NUMBER:570088033661 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.Limits shown are as requested <br />POLICY EXP <br />(MM/DD/YYYY) <br />POLICY EFF <br />(MM/DD/YYYY) <br />SUBR <br />WVD <br />INSR <br />LTR <br />ADDL <br />INSD POLICY NUMBER TYPE OF INSURANCE LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />POLICY LOC <br />EACH OCCURRENCE <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />GENERAL AGGREGATE <br />PRODUCTS - COMP/OP AGG <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRO- <br />JECT <br />OTHER: <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />OWNED <br />AUTOS ONLY <br />SCHEDULED <br /> AUTOS <br />HIRED AUTOS <br />ONLY <br />NON-OWNED <br />AUTOS ONLY <br />BODILY INJURY ( Per person) <br />PROPERTY DAMAGE <br />(Per accident)X X <br />BODILY INJURY (Per accident) <br />$1,000,000B09/01/2020 09/01/2021 COMBINED SINGLE LIMIT <br />(Ea accident) <br />71CAB1006103 <br />EXCESS LIAB <br />OCCUR <br />CLAIMS-MADE AGGREGATE <br />EACH OCCURRENCE <br />DED <br />UMBRELLA LIAB <br />RETENTION <br />E.L. DISEASE-EA EMPLOYEE <br />E.L. DISEASE-POLICY LIMIT <br />E.L. EACH ACCIDENT $1,000,000 <br />X OTH- <br />PER STATUTEB09/01/2020 09/01/2021 <br />74WCI1006003C 09/01/2020 09/01/2021 <br />$1,000,000 <br />Y / N <br />(Mandatory in NH) <br />ANY PROPRIETOR / PARTNER / EXECUTIVE <br />OFFICER/MEMBER EXCLUDED?N / AN <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />$1,000,000 <br />71WCI1005903 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CANCELLATIONCERTIFICATE HOLDER <br />AUTHORIZED REPRESENTATIVEOrange County <br />Attn: Kimberlee Quatrone <br />PO Box 8181 <br />Hillsborough NC 27278 USA <br />ACORD 25 (2016/03) <br />©1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE <br />POLICY PROVISIONS. <br />DocuSign Envelope ID: 1DA2E3C9-2103-4259-9AB2-7F86E8F05F9D