2011-328 Planning - DOT Construction, Inc. for bus shelters at DTCC

Browse Search

�•� OP ID:MM CERTIFICATE OF LIABILITY INSURANCE DATE 09/3030/1YYY) 1 /1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER 704-375-8000 CTACT. Knauff Insurance Agency,Inc. PHONONE FAX P O Box 33789 704-334-6526 c ,Ext• A/C No): Charlotte,NC 28233-3789 E-MAIL Steven Santee ADDRESS: PRODUCER DOTCONS C TO ER ID#: INSURERS AFFORDING COVERAGE NAIC# INSURED DOT Construction,Inc INSURER A:Penn National Mutual Casualty 14990 Ha Chung Kim INSURER B:Great American Insurance Co. 16691 4801 E.Independence Blvd.#506 Charlotte,NC 28212 INSURERC: INSURER D: INSURER E; INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I DUL SUNK POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER M/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 • X COMMERCIAL GENERAL LIABILITY X CL90626971 11130170 11/30/11 PAMAGE TO RENTED Ea occurrence $ 100,00 CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 ', GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 JECT F-]POLICY X PRO LOC $ AUTOMOBILE LIABILITY X COMBINED SINGLE LIMIT $ 1,000,00 • X ANY AUTO AU90626971 11130110 11/30/11 (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIREDAUTOS (Per accident) $ NON-OWNED AUTOS $ X UMBRELLA LIAB X OCCUR X UL90626971 11/30/10 11/30/11 UR EACH OCCURRENCE $ 3,000,00 EXCESS LIAB CLAIMS-MA A DE AGGREGATE $ 3.000,00 X1DEDUCTIBLE $ RETENTION $ 10,000 $ WORKERS COMPENSATION X WCSLAIT BTH AND EMPLOYERS'LIABILITY A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N C90626971 11130110 11/30/11 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBEREXCLUDED? ❑Y NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under 500,00 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Inland Marine CL90626971 11/30/10 11/30/11 Lease/ren 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) Certificate holder is an additional insured on all liability policies except employers liability(WC)with respects to work performed by the named insured for such additional insured if required by written contract signed by an authorized representative of the named Insured. CERTIFICATE HOLDER CANCELLATION ORACOUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Orange County Attn:David Cannel/ PO Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough,NC 27278 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD