Orange County NC Website
6/26/2020 <br />Hays Companies Inc. <br />1200 North Mayfair Road <br />Suite #100 <br />Milwaukee WI 53226 <br />Amy Vossekuil <br />(414)443-0000 <br />Hagerty Consulting, Inc. <br />1618 Orrington Ave, Suite 201 <br />Evanston IL 60201 <br />National Fire Insurance Co of Hartford 20478 <br />Continental Insurance Company 35289 <br />Valley Forge Insurance Company 20508 <br />Certain Underwriters at Lloyds <br />20 <br />A <br />X <br />X <br />X <br />X Y 6023741069 1/1/2020 1/1/2021 <br />1,000,000 <br />500,000 <br />15,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />A <br />X X <br />X Y BUA 6023741055 1/1/2020 1/1/2021 <br />1,000,000 <br />B <br />X X <br />X 10,000 6023741072 1/1/2020 1/1/2021 <br />2,000,000 <br />2,000,000 <br />C 6023741041 (AOS)1/1/2020 1/1/2021 <br />6023741086 (CA) $1M <br />X <br />500,000 <br />500,000 <br />500,000 <br />D Professional W17828200601 1/1/2020 1/1/2021 Ea Claim/Aggregate $2,000,000 <br />EW: FEMA/CRS Consulting Services Agreement <br />County is additional insured and waiver of subrogation applies on above referenced policies where <br />required by written contract. <br />Orange County, North Carolina <br />(County) <br />PO BOX 8181 <br />Attn:Dinah Jeffries <br />Hillsborough, NC 27278 James Hays/FHALAS <br />Y <br />The ACORD name and logo are registered marks of ACORD <br />CERTIFICATE HOLDER <br />©1988-2014 ACORD CORPORATION.All rights reserved. <br />ACORD 25 (2014/01) <br />AUTHORIZED REPRESENTATIVE <br />CANCELLATION <br />DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE <br />LOCJECTPRO-POLICY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />OCCURCLAIMS-MADE <br />COMMERCIAL GENERAL LIABILITY <br />PREMISES (Ea occurrence)$DAMAGE TO RENTED <br />EACH OCCURRENCE $ <br />MED EXP (Any one person)$ <br />PERSONAL &ADV INJURY $ <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMP/OP AGG $ <br />$RETENTIONDED <br />CLAIMS-MADE <br />OCCUR <br />$ <br />AGGREGATE $ <br />EACH OCCURRENCE $UMBRELLA LIAB <br />EXCESS LIAB <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS <br />PER <br />STATUTE <br />OTH- <br />ER <br />E.L.EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />$ <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />If yes,describe under <br />DESCRIPTION OF OPERATIONS below <br />(Mandatory in NH) <br />OFFICER/MEMBER EXCLUDED? <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />HIRED AUTOS NON-OWNED <br />AUTOS AUTOS <br />AUTOS <br />COMBINED SINGLE LIMIT <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE $ <br />$ <br />$ <br />$ <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 />INSD <br />ADDL <br />WVD <br />SUBR <br />N / A <br />$ <br />$ <br />(Ea accident) <br />(Per accident) <br />OTHER: <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />COVERAGES CERTIFICATE NUMBER:REVISION NUMBER: <br />INSURED <br />PHONE(A/C, No, Ext): <br />PRODUCER <br />ADDRESS: <br />E-MAIL <br />FAX <br />(A/C, No): <br />CONTACTNAME: <br />NAIC # <br />INSURER A : <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />INSURER(S)AFFORDING COVERAGE <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 />INS025 (201401) <br />DocuSign Envelope ID: F4067998-FFF7-46D8-9A00-3615ECBE25B8