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r <br />Client#:126284 <br />RESOBUI <br />ACORD <br />CERTIFICATE OF LIABILITY INSURANCE D"'m' <br />TM onlZ a <br />P~ooucER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Wachovia insurance Serv-RA, NC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />PO f3ox 97787 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Raleigh, NC 27624-7787 <br />8 Z2-4154 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED fNSURERA: Westfield National Insurance Company 24120 <br />Resolute Building Company INSURER a: Westfield Insurance Company 24112 <br />PO Box 3656 <br /> INSURER C: <br />Chapel Hill, NC 27515 <br /> INSURER D: <br /> INSURER E: <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />LT TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br />A GENEftALL1ABILITY TRA4527240 10/01/08 1D/D1/09 EACH OCCURRENCE S1 D00000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED s300 ODiI <br /> CLAIMS MADE D OCCUR MED EXP {My one person) S10 OOD <br /> PERSONAL b ADV INJURY S1 OOO OOO <br /> <br /> GENERAL AGGREGATE j2 ODO 000 <br /> X GEN'L AGGREGATE LIMB APPLIES PER: PRODUCTS - COMP/OPAGG SZ 000 OOD <br /> POLICY X jRa LOC <br />A AUTOMOBILE LIABILITY TRA4527240 10/01/08 10/01109 <br /> X ANY AUTO ~~Mao~d~t) INGLE LIMIT j1,000,OOO <br /> ALL OWNED AUT03 <br /> BODILY INJURY j <br /> SCHEDULED AUTOS {Per Person) <br /> X HIRED AUTOS <br /> <br />X BODILY INJURY <br />(P <br />id <br />[ j <br /> NON-OWNED AUTOS er aoc <br />en <br />) <br /> X $250 Comp Ded <br /> X 5500 Coll Ded (P ~a«~demS AGE s <br /> GARAGE LU181LlIY AUTO ONLY - EA ACCIDENT j <br /> ANY AUTO EA ACC <br />OTHER THAN S <br /> AUTO ONLY: AGG S <br />A EXCESSfUMBRELLa IJABILITV TRA452724D 10/D1/08 10/01/09 EACH OCCURRENCE S1D 000 000 <br /> X OCCUR ~ CWMS MADE AGGREGATE j1O 000 000 <br /> S <br /> DEDUCTIBLE <br />S <br /> X RETENTION j O j <br />B WORKERS COMPENSATION AND <br />' <br />B <br />L WCP4527399 10101/08 10!01/D9 X we sTATU- oTH- <br /> EMPLOYERS <br />LIA <br />I <br />ITY <br />ANY PROPRIETORlPARTNERJEXECUTNE <br />E_L. EACH ACCIDENT <br />j1 OO ODO <br />N OFFICERJMEMBER EXCLUDED? <br />der <br />N <br />~ <br />d E.L. DISEASE - EA EMPLOYEE j1 DO OOO <br /> yes, <br />escr <br />e un <br />SPECIAL PROVISIONS Nebw E.L. DISEASE -POLICY LIMIT j500,000 <br /> OTHER <br />DESCRIPTION OF OPERATIONS l LOCATIONS l VEHK:LES i EXCLUSK)NS AODEO BY ENDORSEMENT l SPECUIL PROVISIONS <br />Re: Orange County Library 137 Margaret Lane, Hillsborough, NC <br />Telesis Constructiong Management, LLC, Brockwell and Associates, EDi, Inc. <br />Gardner & McDaniel, PA, Summit Consulting and Orange County are named as <br />additional insureds with respect to General Llabllity and Automobile <br />(See Attached Descriptions) <br />Telesis Construction Management, <br />LLC <br />1000 Corporate Drive, Suite 109 <br />HiNsborough, NC 27278 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER 41fILL ENDEAVOR TO MAIL ~0.._ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LWBILITY OF ANY KIND UPON THE INSURER, ITS AOENTS OR <br />AUTI~7'~ _ -"' <br />ra.a,rrcu za Iswuua/1 O! 3 #51409387/M14D5195 LHA02 ®ACORD CORPORATION 1988 <br />