Orange County NC Website
ACORD 101 (2008/01) <br />The ACORD name and logo are registered marks of ACORD <br />© 2008 ACORD CORPORATION. All rights reserved. <br />THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br />FORM NUMBER:FORM TITLE: <br />ADDITIONAL REMARKS <br />ADDITIONAL REMARKS SCHEDULE Page of <br />AGENCY CUSTOMER ID: <br />LOC #: <br />AGENCY <br />CARRIER NAIC CODE <br />POLICY NUMBER <br />NAMED INSURED <br />EFFECTIVE DATE: <br />Pitney Bowes Inc. <br />3001 Summer Street <br />Stamford, CT 06926 <br />Orange County, North Carolina is included as an Additional Insured as respects to General Liability where required by <br />written contract. <br />INSURER AFFORDING COVERAGE: ACE Fire Underwriters Insurance Company NAIC#: 20702 <br />POLICY NUMBER: SCF C6892201A EFF DATE: 07/01/2022 EXP DATE: 07/01/2023 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Workers Compensation and E.L. Each Accident $2,000,000 <br />Employers’ Liability E.L. Disease - EA Emp $2,000,000 <br />Per Statute E.L. Disease-Pol LMT $2,000,000 <br />INSURER AFFORDING COVERAGE: National Fire & Marine Insurance Company NAIC#: 20079 <br />POLICY NUMBER: 42-XSF-316064-02 EFF DATE: 07/01/2022 EXP DATE: 07/01/2023 <br />TYPE OF INSURANCE: LIMIT DESCRIPTION: LIMIT AMOUNT: <br />Excess Business Auto Limit: $1M xs $2M <br />2 2 <br />Willis Towers Watson Northeast, Inc. <br />See Page 1 <br />See Page 1 See Page 1 See Page 1 <br />25 Certificate of Liability Insurance <br />W28758083CERT:2943549BATCH:24039233SR ID: <br />DocuSign Envelope ID: 08EDAC36-504F-42CC-A3ED-E1FEB674CA74