Orange County NC Website
Hoffman & Hoffman Inc. <br />00001106 <br />MP Specialty Insurance <br />25 Certificate of Liability Insurance <br />Additional Insured - Where Required Under Contract or Agreement - 87950 (09/14); Blanket - Insurance Primary as to Certain Additional Insureds - 74445 <br />(10/99); Blanket Waiver of Transfer of Rights of Recovery Against Others to Us - Business Auto Coverage Form - 62897 (06/95); Blanket Limited Advice of <br />Business Auto Cancellation Provided via E-Mail To Entities Other Than The First Name Insured - 107414 (03/11); Blanket Workers Compensation Waiver of <br />Our Right To Recover From Others Endorsement - WC000313 (04/84); Blanket Limited Advice Cancellation Provided via E-Mail To Entities Other Than The <br />Named Insured (Workers Compensation Only) WC990056 (04/11); Excess Follow-Form and Umbrella Liability Additional Insured - EU0001 (07/16) Pg 4 of <br />23; Coverage is Primary & Non-Contributory - EU0001 (07/16) Pg 15 of 23; Waiver or Transfer of Subrogation - EU0001 (07/16) Pg 16 of 23; Aggregated <br />Limit Applies on a Per Project Basis - EU0113 (07/16); Blanket Designated Entity - (30) Day Notice of Cancellation Provided by Us - ILT405 (05/19). <br />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 />DocuSign Envelope ID: EF4B1761-E191-4214-9651-0FC3E17A972A