Orange County NC Website
<br /> CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br /> 06/26/2023 <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 <br />Vouch Insurance Services, LLC <br />3739 Balboa St #1073 <br />San Francisco, CA 94121 <br />CONTACT <br />NAME: <br />PHONE <br />(A/C, No, Ext): <br />FAX <br />(A/C, No): <br />E-MAIL <br />ADDRESS <br />: <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A : State National Insurance Company 12831 <br />INSURED <br />Personnel Technology, LLC <br />1202 Yardley Ln <br />Wilmington, NC 28412 <br />INSURER B : United Specialty Insurance Company 12537 <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGES CERTIFICATE NUMBER: 3 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. <br />INSR <br />LTR TYPE OF INSURANCE ADDL <br />INSR <br />SUBR <br />WVD POLICY NUMBER POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY) LIMITS <br />A <br /> COMMERCIAL GENERAL LIABILITY <br />Y HDG.BOP.23.SDKH-374K 06-16-2023 06-16-2024 <br />EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE X OCCUR DAMAGE TO RENTED <br />PREMISES (Ea occurrence) $50,000 <br />X Business Liability MED EXP (Any one person) $10,000 <br /> PERSONAL & ADV INJURY EXCLUDED <br />GEN’L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br />X POLICY PRO-JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 <br /> OTHER: $ <br /> <br />AUTOMOBILE LIABILITY <br /> <br />COMBINED SINGLE LIMIT <br />(Ea accident) $ <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> OWNED <br />AUTOS ONLY <br />HIRED <br />AUTOS ONLY <br /> SCHEDULED <br />AUTOS <br />NON-OWNED <br />AUTOS ONLY <br />BODILY INJURY (Per accident) $ <br /> PROPERTY DAMAGE <br />(Per accident) $ <br /> Per Occurrence Limit $ <br /> <br /> UMBRELLA <br />LIAB EXCESS <br />LIAB <br /> OCCUR <br />CLAIMS-MADE <br />EACH OCCURRENCE $ <br /> EXCESS LIAB AGGREGATE $ <br /> DED RETENTION $ $ <br /> <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br /> <br /> <br /> <br />N / A <br /> <br /> <br /> PER STATUTE OTH- ER <br />E.L. EACH ACCIDENT $ <br />E.L. DISEASE - EA EMPLOYEE $ <br />E.L. DISEASE - POLICY LIMIT $ <br />B Errors & Omissions Liability <br />Cyber-First Party <br />Cyber-Third Party Liability <br />HDG.CEM.23.RXIU-3PU1 06-16-2023 06-16-2024 Policy Aggregate Limit: $1,000,000 <br />Cyber Aggregate Limit: $1,000,000 <br />Errors & Omissions Limit: $1,000,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Insurer B: HDG.CEM.23.RXIU-3PU1, 06-16-2023 -06-16-2024 <br />Policy Aggregate Limit of Liability: $500,000 <br />Management Liability (D&O) Limit: $500,000 <br /> <br />Additional Insured endorsement (BP 04 48) issued for: Orange County, its officers, agents and employees (effective 06/26/2023). <br />Provided, however, Orange County, its officers, agents and employees are additional insureds only the extent that liabilities fall within obligations of Personnel Technology, LLC to <br />indemnify such additional insured pursuant to a written agreement. <br /> <br />CERTIFICATE HOLDER CANCELLATION <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <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 /> <br /> <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 />AUTHORIZED REPRESENTATIVE <br /> <br />John Wallace <br />(415) 488-6728 <br />cois@vouch.us <br /> <br />Orange County <br />300 West Tryon St P.O. Box 8181 <br />Hillsborough, NC 27278 <br />DocuSign Envelope ID: 20294076-4C52-4D16-AEB5-11525F0852A4