Orange County NC Website
Holder Identifier : 7777777707070700077763616065553330763735764015474607762215770634132071660557146323320756041733247411007744415716234754073620355320541320770621555227657007364235552274130077727252025773110777777707000707007 6666666606060600062606466204446200622200606204220006220206260040220062220240622422200620000604026202006200026062260200060200062620400200622200406000242006222064020640040066646062240664440666666606000606006Certificate No : 570082630418 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 06/29/2020 <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 />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 />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(A/C. No. Ext): <br />E-MAILADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />(415) 486-7000 <br />INSURED 11150Arch Insurance CompanyINSURER A: <br />30830Arch Indemnity Insurance CompanyINSURER B: <br />27960Illinois Union Insurance CompanyINSURER C: <br />0299ALSpectrum Insurance Company, IncINSURER D: <br />19437Lexington Insurance CompanyINSURER E: <br />INSURER F: <br />FAX(A/C. No.):(415) 486-7029 <br />CONTACTNAME: <br />AMN Healthcare, Inc. <br />12400 High Bluff Drive <br />San Diego CA 92130-3077 USA <br />COVERAGES CERTIFICATE NUMBER:570082630418 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 />Limits shown are as requested <br />POLICY EXP (MM/DD/YYYY)POLICY EFF (MM/DD/YYYY)SUBRWVDINSR LTR ADDL 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 />X <br />X <br />X <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />$1,000,000 <br />$100,000 <br />$5,000 <br />$1,000,000 <br />$3,000,000 <br />$1,000,000 <br />E 03/01/2020 03/01/202111466377 <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 />$1,000,000A09/01/2019 09/01/2020 COMBINED SINGLE LIMIT <br />(Ea accident)71CAB1006102 <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-ERPER STATUTEA09/01/2019 09/01/2020 <br />74WCI1006002B 09/01/2019 09/01/2020 <br />$1,000,000 <br />Y / N <br />(Mandatory in NH) <br />ANY PROPRIETOR / PARTNER / <br />EXECUTIVE OFFICER/MEMBER N / AN <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />If yes, describe under DESCRIPTION OF OPERATIONS below <br />$1,000,000 <br />71WCI1005902 <br />Per Incident1146637703/01/2020 03/01/2021 <br />$4,000,000Aggregate <br />HPLE $2,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Workers' compensation program has a $500,000 deductible. Orange County is included as Additional Insured in accordance with the <br />policy provisions of the General Liability policy. <br />CANCELLATIONCERTIFICATE HOLDER <br />AUTHORIZED REPRESENTATIVEOrange County <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 EXPIRATION <br />DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />DocuSign Envelope ID: CCF26BE9-7139-4CD7-B14B-F0FE9E767491