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Client: 126284 <br />RFRARIII <br />ACORD <br />CERTIFICATE OF LIABILITY INSURANCE ~' <br />,~ 12/O7/200i <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Wachovia Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />PO Box 97787 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Raleigh, NC 27624-7787 <br />P:919~76-8834 F:919-676-3307 INSURERS AFFORDING COVERAGE NAIC # <br />INSURED INSURER A: AmerlSUre COmpanleS 19488 <br />Resolute Building Company INSURER B: Amerisure Mutual Insurance Company <br />PO Box 3656 INSURER C: Amerisure Insurance Company <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 />LTR N R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br />A GENERAL LIABILITY CPP2073875050007 10/01/07 10/01/08 EACH OCCURRENCE $1 000 pOp <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $300 000 <br /> CLAIMS MADE ~ OCCUR MED EXP (Any one person) $10 000 <br /> PERSONAL & ADV INJURY $1 OOO 000 <br /> GENERAL AGGREGATE $2 000 000 <br /> X GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $2 000 000 <br /> POLICY X jE OT- LOC <br />C AUT OMOBILE LIABILITY CA2013873050007 10/01/07 10/07/08 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) $1x000,000 <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> X HIRED AUTOS BODILY INJURY <br /> X NON-OWNED AUTOS (Per accident) $ <br /> X $250 Comp Ded PROPERTY DAMAGE <br /> X $500 COII Ded (Peraccidenq $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br />B EXCESS/UMBRELLA LIABILITY CU2013877 10/01/07 10/01/08 EACH OCCURRENCE $10 000 000 <br /> X OCCUR ~ CLAIMS MADE AGGREGATE $1 O 000 000 <br /> <br /> DEDUCTIBLE $ <br /> X RETENTION $ O $ <br />B WORKERS COMPENSATION AND WC201388105 10/01/07 10/01/0$ ~( WC sTATU- oTH- <br /> EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $100 000 <br /> <br />N ANY PROPRIETORIPARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED9 <br />E.L. DISEASE - EA EMPLOYEE <br />$100 OOO <br /> If yes, describe under <br />SPECIAL PROVISIONS below <br />E.L. DISEASE -POLICY LIMIT <br />$500 000 <br /> OTHER <br />DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />Project: Orange County Emergency Services Center, 510 Meadowlands Drive, <br />Hillsboro, NC. The County of Orange is additional insured as respects <br />general liability coverage. All polices referenced on this Certificate <br />have been endorsed to provide 30 days notice of cancellation or non <br />renewal by Registered mail to the County of Orange (endorsements attached). <br />County of Orange <br />PO Box 8181 <br />Hillsborough, NC 27278 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _3p._ DAVS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATNE <br />ACORD 25 (2001/08) 1 Of 2 #S1289666/M1263070 EPA01 ~ ACORD CORPORATION 1988 <br />