Orange County NC Website
CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />PRODUCER <br />INSURED <br />INSURER A : <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />COVERAGES <br />TYPE OF INSURANCE POLICY NUMBER LIMITS <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />LOCPOLICY <br />OTHER: <br />EACH OCCURRENCE <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />GENERAL AGGREGATE <br />PRODUCTS - COMP/OP AGG <br />$ <br />$ <br />$ <br />$ <br />$ <br />$ <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />$ <br />$ <br />$ <br />$ <br />OCCUR <br />CLAIMS-MADE <br />DED RETENTION $ <br />EACH OCCURRENCE <br />AGGREGATE <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />$ <br />$ <br />$ <br />$ <br />$ <br />Y/N <br />CONTACT <br />NAME: <br />PHONE <br />(A/C, No, Ext): <br />E-MAIL <br />ADDRESS: <br />FAX <br />(A/C, No): <br />CERTIFICATE NUMBER:REVISION NUMBER: <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />AUTHORIZED REPRESENTATIVE <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD <br />$ <br />INSURER F : <br />$ <br />N/A <br />SCHEDULED <br />AUTOS <br />NON-OWNED <br />AUTOS ONLY <br />OWNED <br />AUTOS ONLY <br />HIRED <br />AUTOS ONLY <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 <br />ADDL <br />INSD <br />POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY) <br />PRO- <br />JECT <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />PER <br />STATUTE <br />OTH- <br />ER <br />SUBR <br />WVD <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 />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 /> <br />06/02/2025 <br />GEICO INSURANCE AGENCY, LLC <br />1 GEICO BLVD 4TH FLOOR <br />FREDERICKSBURG, VA 22412 <br />(888) 661-3938 <br /> <br />(888) 661-3938 (877) 872-7604 <br />service.center@travelers.com <br />SAKY <br />101 BUENA VISTA WAY <br />CHAPEL HILL, NC 27514 <br />ST. PAUL FIRE AND MARINE INSURANCE COMPANY <br />289599126411351 <br />A X <br />X <br />X <br />X BIP-B446262A-25 05/23/2025 05/23/2026 1,000,000 <br />300,000 <br />5,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />AS RESPECTS TO GENERAL LIABILITY, CERTIFICATE HOLDER IS ADDITIONAL INSURED PER FORM COMMERCIAL GENERAL LIABILITY <br />COVERAGE FORM - CG T1 00 - MANAGERS OR LESSORS OF PREMISES FOR THE FOLLOWING LOCATION: 101 BUENA VISTA WAY, CHAPEL <br />HILL, NC 27514. <br />HEDGEHOG HOLDINGS <br />1100 LAKE FOREST ROAD. <br />RALEIGH, NC 27604 <br />Docusign Envelope ID: F69322A8-0C9B-4646-BE14-8A02D76E982A