Orange County NC Website
ACORD CERTIFICATE OF LIABILITY INSURANCE <br />° DA <br />oe <br />sRO <br />oK 9 01 <br />os <br />PRODUCER THIS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION <br />Senn Dunn Marsh & Roland, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />3625 N. Elm Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P O Box 9375 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Greensboro NC 27429-0375 <br />Phone:336-272-7161 Fax:336-346-1397 . INSURERS AFFORDING COVERAGE NAIC# <br />INSURED <br />Brooks Lumber Company INSURERA Cincinnati Insurance Co. <br />Brooks General Contractors <br />B <br />k <br />Mill INSURER B: Cincinnati casualty company <br />roo <br />s <br />work Company <br /> <br />302 West Lee Street INSURERc <br />PO Box 3244 <br /> <br />Greensboro NC 27402 INSURER D: <br /> INSURER E: <br />avverwues <br />THE POUGES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDfTION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POUGES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CUUMS. <br />LTR NS TYPE OF INSURANCE POLICY NUMBER DATE MlDD/YY DATE MMID LIMITS <br /> GENERAL LU161LTTY EAGi OCCURRENCE $ 1 , OOO , OOO <br />A X COMMERCIAL GENERALLL481LITY CPP0864595 07/01/07 07/01/08 PREMISES Eaoccurence S 100,000 <br /> CLAIMS MADE a OCCUR MED EXP (Any one person) $ cj ~ 000 <br /> DEDUCTIBLE - $1,00 PERSONAL&ADVINJURY $ 1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , OOO , OOO <br /> POLICY X JET LOC Em Ben . 1, OOO , OOO <br /> AUT OMOBILE LU161LTTY <br />B <br />INGLE <br />T <br /> ~ <br />t <br />LIMI g 1,000,000 <br />A X ANYquro CPA0864595 07/01/07 07/01/08 ~e <br />~ <br />) <br /> ALL OWNED AUTOS BODILY INJURY <br /> $ <br /> SCHEDULED AUTOS (fir person) <br /> X HIRED AUTOS <br />BODILY INJURY <br /> $ <br /> X NON-0WNEDAUTOS (Per accident) <br />X Deductible AOTO LIABILITY- NO DEDUCT PROPFJ3TY DAMAGE <br /> $ <br /> - (Per accident) <br /> GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ <br /> ANY AUTO EA ACC <br />OTHER THAN $ <br /> AUTO ONLY: AGG S <br /> E%CESSNMBRELLALU161LTTY EAGiOCCURRENCE $5 000,000 <br />A X OCCUR ~ CLAIMS MADE CPP0864595 07/01/07 07/01/08 AGGREGATE $ 5, 000, 000 <br /> $ <br /> DEDUCTIBLE $ <br /> X RETENTION $ O $ <br /> WORKERS COMPENSATION AND <br />' X TORY LIMITS ER <br />A EMPLOYERS <br />LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE WC2100050-05 07/01/07 07/01/08 EL EACHACGDENT $ 100 OOO <br />~ <br /> OFFICERIMEMBER EXCLUDEJ)9 <br />If <br />i <br />d E.L DISEASE - EA EMPLOYEE $ ZOO , OOO <br /> yes <br />escr <br />be under <br />SPECIAL PROVISIONS below <br />E.LDISEASE-POUCYUMIT <br />$5OO OOO <br /> OTHER <br />A Builders Risk CPP0864595 07/01/07 07/01/08 Max/Bldg $ 4,000,000 <br /> $ 1,000 Deductible Max/Loss $ 4,000,000 <br />DESCRIPTION OF OPERATIONS LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT / SPECULL PROVISIONS <br />RE: West Ten Soccer Center- Phase II, Orange County, NC CRZ Project <br />#0421. Certificate holder is listed as additional insured as respects to <br />general liability as required by written contract. Not withstanding the <br />preprinted cancellation provisions on this form, coverages afforded under <br />the policies will not be canceled, reduced in amount nor will any <br />CERTIFICATE HOLDER CANCELLATION <br />County of Orange <br />Po Box 8181 <br />Hillsborough NC 27278 <br />ACORD 25 (2001 <br />C~UNTYl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LUU3ILTTY OF ANY qND UPON THE INSURER ITS AGENTS OR <br />REPRESENTATIVES. <br />~~ Rf.1 ~ G-'~~, <br />1988 <br />