Orange County NC Website
DocuSign Envelope ID: B6D35DB5-OB41-46CD-95BD-776CC3B7F4F8 <br /> DATE(MM/DD/YYYY) <br /> ,acoRo° CERTIFICATE OF LIABILITY INSURANCEF�� 11/9/2021 10/7/2021 <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 Lockton Insurance Brokers,LLC CONTACT <br /> NAME: <br /> CA License#OF15767 PHONE FAX <br /> Three Embarcadero Center,Suite 600 E MAILo Ext: A/C No <br /> San Francisco CA 94111 ADDRESS: <br /> (415)568-4000 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:The Continental Insurance Company 35289 <br /> INSURED Dude Solutions,Inc. INSURER B:American Casualty Company of Reading,PA 20427 <br /> 1466501 11000 Regency Parkway,#400 INSURER C:Everest National Insurance Company 10120 <br /> Cary NC 27518 INSURER D:Continental Casualty Company 20443 <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES DUDS002 CERTIFICATE NUMBER: 17627694 REVISION NUMBER: XXXXXXX <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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DDIYYYY MM/DDIYYYY <br /> A X COMMERCIAL GENERAL LIABILITY N N 6078704688 10/1/2021 10/1/2022 EACH OCCURRENCE $ 1,000,000 <br /> A AGE To ENTED <br /> CLAIMS-MADE �OCCUR PREM MIS <br /> Ea occu ence $ 1 0OO 0OO <br /> MED EXP(Any one person) $ 15,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY[X]JE� X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY N N 6078704674 10/1/2021 10/1/2022 Ea BI EDtSINGLE LIMIT $ 1,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ XXXXXXX <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS XXXXXXX <br /> X HIRED X NON-OWNED PROPERTY DAMAGE $ XXXXXXX <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> X Comp.$100/ oil. 1K $ XXXXXXX <br /> A X UMBRELLA LIAB X OCCUR N N 6078704710 10/1/2021 10/1/2022 EACH OCCURRENCE $ 10,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 <br /> DED RETENTION$ $ XXXXXXX <br /> WORKERS COMPENSATION PER OTH- <br /> B AND EMPLOYERS'LIABILITY N 6078704691(CA) 11/9/2020 11/9/2021 X STATUTE ER <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 6078704707(AOS) 11/9/2020 11/9/2021 E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? FNI N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> C Primary E&O/Cyber N N CYBP000223-201 10/2/2021 10/2/2022 $5M <br /> D Excess E&O/Cyber 652376492 10/2/2021 10/2/2022 $5M xs$5M <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Evidence of insurance only. <br /> CERTIFICATE HOLDER CANCELLATION See Attachment <br /> 17627694 <br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Hillsborough NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPR E ATIVE <br /> wzt�� <br /> V(I- <br /> ©1988-2015 ACORD CORPORATI . All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />