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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 />INSURER(S) AFFORDING COVERAGE
<br />INSURER F :
<br />INSURER E :
<br />INSURER D :
<br />INSURER C :
<br />INSURER B :
<br />INSURER A :
<br />NAIC #
<br />NAME:CONTACT
<br />(A/C, No):FAX
<br />E-MAILADDRESS:
<br />PRODUCER
<br />(A/C, No, Ext):PHONE
<br />INSURED
<br />REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES
<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 />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 />OTHER:
<br />(Per accident)
<br />(Ea accident)
<br />$
<br />$
<br />N / A
<br />SUBR
<br />WVD
<br />ADDL
<br />INSD
<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 />$
<br />$
<br />$
<br />$PROPERTY DAMAGE
<br />BODILY INJURY (Per accident)
<br />BODILY INJURY (Per person)
<br />COMBINED SINGLE LIMIT
<br />AUTOS ONLY
<br />AUTOSAUTOS ONLY NON-OWNED
<br />SCHEDULEDOWNED
<br />ANY AUTO
<br />AUTOMOBILE LIABILITY
<br />Y / N
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />OFFICER/MEMBER EXCLUDED?(Mandatory in NH)
<br />DESCRIPTION OF OPERATIONS belowIf yes, describe under
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />$
<br />$
<br />$
<br />E.L. DISEASE - POLICY LIMIT
<br />E.L. DISEASE - EA EMPLOYEE
<br />E.L. EACH ACCIDENT
<br />EROTH-STATUTEPER
<br />LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />EXCESS LIAB
<br />UMBRELLA LIAB $EACH OCCURRENCE
<br />$AGGREGATE
<br />$
<br />OCCUR
<br />CLAIMS-MADE
<br />DED RETENTION $
<br />$PRODUCTS - COMP/OP AGG
<br />$GENERAL AGGREGATE
<br />$PERSONAL & ADV INJURY
<br />$MED EXP (Any one person)
<br />$EACH OCCURRENCE
<br />DAMAGE TO RENTED $PREMISES (Ea occurrence)
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS-MADE OCCUR
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY PRO-JECT LOC
<br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
<br />CANCELLATION
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016/03)
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.
<br />CERTIFICATE HOLDER
<br />The ACORD name and logo are registered marks of ACORD
<br />HIREDAUTOS ONLY
<br />07/15/2024
<br />J&A Insurance Agency Inc.
<br />1300 Ridenour Blvd. Ste. 100
<br />Kennesaw GA 30152
<br />Joe Jaynes
<br />(678) 266-3353 (678) 266-3353
<br />jj@jainsuranceagency.com
<br />Ems Technology Solutions, LLC dba Operative IQ
<br />3781 Tramore Pointe Pkwy.
<br />Austell GA 30106
<br />Hartford Underwriters Insurance Company
<br />Nutmeg Ins. Co.
<br />Hartford Underwriters Insurance Company
<br />Farmington Casualty Ins. Co.
<br />Hartford Underwriters Insurance Company
<br />Twin City Fire Insurance Co.
<br />A Y 20SBABC6GBS 07/18/2024 07/18/2025
<br />2,000,000
<br />1,000,000
<br />10,000
<br />2,000,000
<br />4,000,000
<br />4,000,000
<br />B Y 20UECEL7367 07/18/2024 07/18/2024
<br />1,000,000
<br />C
<br />10,000
<br />Y 20SBABC6GBS 07/18/2024 07/18/2025
<br />1,000,000
<br />1,000,000
<br />D Y Y UB7J299281 07/18/2024 07/18/2025 1,000,000
<br />1,000,000
<br />1,000,000
<br />E Technology Errors and Omissions
<br />Self Insd. Retention limit $10,000 20SBABC6GBS 07/18/2024 07/18/2025
<br />per glitch $2,000,000
<br />aggregate $2,000,000
<br />retention limit: $10,000
<br />F. CyberChoice First Response Policy (3rd Party Cyber Liab.), Pol.#20MB 0349843-24, Eff. 7-18-24 to 7-18-25, $2mm Combined Aggreg. limit, Data Privacy
<br />and Network Security Liab. and Expense Ins. Limit $2mm ($10,000 retention limit), Digital Media Liab. limit $2mm ($10,000 retention limit).
<br />Certificate Holder is also an additional insured per pol.# 20SBABC6GBS Form SL 30 32 06 21 "when required by written agreement."
<br />Policy# 20UECEL7367- Certificate Holder is also an Additional Insured per policy form HA 99 16 12 21 when required by written agreement.
<br />Policy# UB7J299281 - Waiver of Subrogation applies per policy Blanket Waiver of Subrogation form..When our insured has agreed by executed written
<br />contract.
<br />Orange County
<br />300 West Tryon Street, P.O. Box 8181
<br />Hillsborough, NC 27278
<br />mtegeder@orangecountync.gov
<br />Joe Jaynes, Agency Principal
<br />Docusign Envelope ID: 1932CF31-D716-4BA9-BABC-753157B59C95
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