Orange County NC Website
Exhibit D <br /> ACCOR" CERTIFICATE OF LIABILITY INSURANCE Dl �(MMIDDIYYYY) <br /> ll.. � 1 06/04/2024 <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 CONTACT NAME: Kenneth Little <br /> Little Insurance aIC No Ext: (910)692-6881 FA No): (910)692-1863 <br /> PO Box 629 ADDRESS: littlek70@aol.com <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> SOUTHERN PINES NC 28388 INSURER A: NATIONWIDE ASSURANCE CO 10723 <br /> INSURED INSURERB; SELECTIVE INSURANCE 19259 <br /> National Public Safety Group, LLC INSURER C: LLOYD'S OF LONDON AA112 <br /> 124 Newington Way INSURER D: <br /> INSURER E: <br /> Aberdeen NC 28315 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> RENTED <br /> CLAIMS-MADE � OCCUR PREM SESOEa occurrence) <br /> ccurrrence $ 100,000 <br /> X Primary&Non-Contributory MED EXP(Any one person) $ 5,000 <br /> A Y Y ACP CGO13059354982 06/15/2024 06/15/2025 PERSONAL&ADV INJURY $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> X POLICY❑ JECT PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,000 <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED ACP CGO13059354982 06/15/2024 06/15/2025 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> XHIRED �/ NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY X AUTOS ONLY Per accident <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION X STATUTE ERPER H <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 <br /> B OFFICER/MEMBER EXCLUDED? ❑ N/A Y WC 9070375 07/11/2024 07/11/2025 <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 /> Professional Liability Each Occurrence $2,000,000 <br /> C W2DA39229201 01/01/2024 01/01/2025 Aggregate $2,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> The County of Orange, NC is an Additional Insured under the General Liability Policy.. Primary and Non-Contributory-Other Insurance Condition applies to the <br /> General Liability policy endorsement CG 20 10 04 13.Waiver of Subrogation applies under both the General Liability and the Workers Compensation policies. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> The County of Orange ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 106 E Margaret Lane AUTHORIZED REPRESENTATIVE <br /> Kenneth Little <br /> Hillsborough NC 27278 <br /> @ 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />