|
47.
<br />A~ ~ ~Er~~r~-~~e~;TE of ~a~:eitr~r~ r~su~~rvc~ 2"~6 a~ ~i
<br />THIS .CERTIFICATE IS ISSUED- AS A iV1ATTER OF INFOf2NiATlOi~t ONLY ANb .CONFERS .NO RfGHTS URON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR hIEGATiVIztY. AMENp, EX7EAtD bR ALTER Ti•tE COVERAGE AFFORDED I3Y THE POLICIES
<br />BELOW. THIS. CERTIFICATE OF INSURANCE DOES NOT CONSTRUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />• REPRESENTATIVE OR PRODUCER, AND THE CERTIFICA'T'E HOLDER. -
<br />INIPORTANTi if the certificate haldeT Is an ADDITIONAL INSURED, the policy(tes) must be endorsed. If SUBROGATION tS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement A statement on this certiftcate daps not confer rights to the
<br />certificate holder in lieu Gf such endorsoment(s).
<br />hRODUCER ~ CN~~CTJu1i.B S1:ZESISOY6
<br />PEtini.lC IASUrance & k'inanciai Services PRO Nfz.Eat1. (819) 459-8000 `__Li~.. Help (919)459-801Q Y
<br />166 Ridgeview Drive mss; julie.sixeanore.$peinik:cdm ~ ..W
<br />Su1te 100 nROmuuao,nsi10007SOO _____...._..__._,,_-._,__.__.___~._
<br />JUDY D BROQIC3 CONTRACTOR INC.
<br />3.195 BF.AL RD
<br />GOI:DSTOIJ NC 27252-9595 INSUa~RP~ v .M_~~f .~~-1
<br />COVERAGES eFarrrleere wIaROCOrr.T i of cno~a ~ nrv,n, ~:a .o ..
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED: BELOW. HAVE BEEN ISSUED TO THE INSURED NAMED ABQVE-FUR THE POLICY PERIOD
<br />INDICATED: NOTWITHSTANDING ANY REQUIREMENT, TERM.OR CONDITN7N OF AftY CONTRACT OR OTHER DOCIIMF_NT' VJiT1-i RESt'ECT TO iNHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN; TtIE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS:SUBJECT TO ALL 'fHE TERMS
<br />,
<br />EXCLUSIONS AND COIdDl7lONS OF SUCH POL-GIES. LIMITS SHOWN MAY IdAVE BEEN REDUCEb BY PAID CLAIMS:
<br />-.:_~.
<br />-
<br />..
<br />. INSR
<br />LTR '
<br />.
<br />....'._'-
<br />TYPEOFINSURANCE S "--
<br />POLICYNUMflER -PCi1JCY EFF~
<br />M/00 POLICY EXP
<br />~ p ..___._--.---
<br />LIMfT9
<br /> GENERAL uaBILrtY EACH OGOURRENCE $ i, 000.; 000
<br /> K COMMERGAL OENEML LIABILITY Pi'>$vU:~R`TS~i3~hl9~b T
<br />~~
<br />L~tr~~tr~~}
<br />300,000
<br />;
<br />~
<br />A ,,.CLAIMS-MAD'cOCCUR P6000154 /18/2011 /18/2012 .
<br />_
<br />,
<br />MEgEXP(AnprMOmperpSlZ, .
<br />._.~.
<br />$__~~-,5,QOLI
<br /> - -_-•~._ ~ PERSONALd.AOY
<br />(NJURY~ 'OOO
<br />$ I
<br />OO
<br />O.
<br /> y__.._.-,. ~
<br />~ ,
<br />,
<br />.
<br /> ---. _ GENNERAL AGGREGATE OV O:; O~ o
<br />s 2:
<br /> _ ,
<br /> GFJtL AGGRE6A7E LIMIT APPLIE6 PER: ~ PRODUCES-COndPlOP AGG, E 2,,~000,OOb
<br /> X POLICY PRO• LOC - $
<br /> AtlT OMOflILE UABtLRY C4MBMtE1? SINCafJ:'LiMIT S 1 , OOO
<br />O~OO
<br /> % ANY Auto (Ea aaiopM3 ,
<br />..
<br />.
<br />.
<br />~
<br />
<br />A
<br />~
<br />nlt OWNED Autos
<br />600pi54
<br />/18/2011
<br />/16/2012
<br />flOOILYtMJUBYiPorppisorlj ..
<br />..
<br />.........-...-_
<br />S
<br />.
<br /> _
<br />_ -
<br />
<br />SCHEDULED RUTOS
<br />BODILY INJURY {Poi acddonti ..,_..__,_r
<br />._,
<br />S-~
<br />_._
<br />.
<br />.
<br />-
<br />
<br />_ _
<br />
<br />X
<br />PROPERTY-OAMAGE ,_..
<br />_,
<br />.
<br />.
<br />S
<br /> HIRF~AUTOS IPQf PCiitfptil)
<br />__
<br />_.
<br />.
<br />.
<br />- ._
<br />__._.
<br />:
<br /> ~ NON•OWNEpAUTOS _
<br />.
<br />.
<br />_
<br />_ $v
<br />.
<br />_.
<br />.,.._.~_.-
<br />
<br /> X UMBRELLA LIAB
<br />_ OCCUR
<br />EACH occuRRENCE
<br />S 6x000, 000
<br />
<br />_ DCCESS LIAB
<br />_._._.__._._.__ CLAIMS•MAOE
<br />_
<br />AGGREGATE
<br />$ 6,f}0o;0ao
<br /> __
<br /> _ DEDUCTJBLE
<br />- .,._
<br />_. -~.~~.-""- S
<br />A % RETENTION $ 10 OOO P6000154 /19/2011 /18/2012 . $ v_--
<br />$ WORKERSCOh1PENSATiON
<br />AND EMPLOYERS' UAfl1UTY WC5TATU• OTH-
<br />~ I
<br />TDI3Y LIMIT
<br />-
<br /> YIN
<br />ANY PROPRIETORlPARTNERlExECUTIVE _
<br />OFFlCERlMEI.SIIER F3CGLUDED7~
<br />N 7-A .
<br />.
<br />EL. EACH ACCIDENT
<br />~ _. _._..__.._..,..~._.
<br />$~ 1 , 000 OOO
<br />,c.._
<br /> (MahdnlaryidNHj
<br />11yes
<br />dpapiM, urWOr P1000641 ~ ~ /18/2011 /18/2012 EL_DISEASE-~i~~EMpI,OYE
<br />~ $ _~ 1. OO^ 000
<br />-
<br /> ~
<br />-DESCRIPTION OFOPE
<br />A
<br /> R
<br />YIONSbdax EL. DISEASE-.POil6YLiMiT S 1 OOO: OOO
<br />C Motor Truck Ca=go- 12125 Ii/2011 /1/2012 Umit $25,000
<br /> Ooauewda $1; 000
<br />DESCRIPTION OP OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACOR6 tot, Atlditlprrpt Rpmarka~SchpQulp,11 mptp ppaw 1¢ rpqulredj
<br />{ 919) 6fi1-9035 _ SHOULD ANY OF THE A90VE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE. EYPiR:4TION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />!tC(-rrr•;„. E WITH THE POLICY PROVISIONS.
<br />I
<br />' ~~ AUTIIGltizt~:ti REPRESENTATNE.
<br />I.7uiie Sizemore/JSZld ~n=~`~*~~ I
<br />AGORD 2$ (2009/09) OO 198&2009 ACORD CORP~RATidN_ All rights rpsPrvrzd- 1
<br />rvauza izollso9l I ne wcURD name and logo are registered marks of ACORD
<br />
|