Orange County NC Website
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 />EXCEINC-01 <br />1 1 <br />JD Fulwiler &Co Ins Excellance Inc <br />453 Lanier Rd <br />Madison AL 35758 <br />25 CERTIFICATE OF LIABILITY INSURANCE <br />1)453 Lanier Rd.Madison AL 35758 <br />$2,000,000 Comprehensive <br />$2,000,000 Collision <br />Location: <br />2)504 Lanier Rd.Madison AL 35758 <br />$2,000,000 Comprehensive <br />$2,000,000 Collision <br />Coverage Basis: <br />Direct Primary <br />Deductibles: <br />COMPREHENSIVE <br />All Other Deductible: <br />Deductible:$2,500/$10,000 Max <br />Earthquake,Flood,&Windstorm and Hail Deductible: <br />Deductible:$2,500/$250,000 Max <br />Collision <br />$1,000 <br />*LIMITS FOR AUTOS HELD FOR SALE BY NON DEALERS: <br />Location: <br />1)453 Lanier Rd.Madison AL 35758 <br />$500,000 Comprehensive <br />$500,000 Collision <br />Location: <br />2)504 Lanier Rd.Madison AL 35758 <br />$500,000 Comprehensive <br />$500,000 Collision <br />$1,000,000 Unnamed Locations <br />$500,000 In Transit <br />Deductibles: <br />COMPREHENSIVE <br />All Other Deductible: <br />Deductible:$2,500/$10,000 Max <br />Earthquake,Flood,&Windstorm and Hail Deductible: <br />Deductible:$2,500/$250,000 Max <br />Collision <br />$1,000 <br />#of Dealer Plates (10) <br />Orange County,its officers,agents and employees are designated as additionally insured as respects operations of the named insured in accordance with the <br />policy terms,conditions &exclusions.Primary Non-Contributory and Waiver of Subrogation apply. <br />Docusign Envelope ID: EF1EEE70-841D-4BBC-A429-CADADA6E1ED9