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OP ID:CM <br /> DATE(MM/DD/YYYY) <br /> CERTIFICATE OF LIABILITY INSURANCE 09/08/11 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> CON ACT Carla Moore <br /> PRODUCER 919-96811472 NAME: <br /> Summers Thompson Lowry,Inc. 919-942-4221 PHONE 919-969-5337 FAX No)-919-942-4221 <br /> 100 Europa Drive,Suite 571 - No Ext <br /> Chapel Hill,NC 27517 E-MAIL carla@stlinsure.com <br /> ADDRESS: <br /> Colonial Insurance Agency of PRODUCER WARRE-1 <br /> CUSTOMER ID N: <br /> INSURER(S)AFFORDING COVERAGE NAIC B <br /> INSURED Warren Hay Mechanical INSURER A:Netherlands <br /> Contractors Inc, INSURER B:Peerles Insurance Company <br /> Sheet Metal Duct Suppliers LLC INSURER C: <br /> PO Box 818 <br /> Hillsborough,NC 27278 INSURER o <br /> INSURERE: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> POLICY E POLICY EXP <br /> LTR FF TYPE OF INSURANCE POLICY NUMBER MMI MMIDD LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> A X COMMERCIAL GENERAL LIABILITY CBP5133655 12131110 12/31/11 PREMISES Ea occurrence $ 300,00 <br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 15,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 <br /> POLICY X PRa LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 <br /> 12/31/10 12/31/11 (Ea accident) <br /> B X ANY AUTO BA5133651 BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS BODILY INJURY(Per accident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE $ <br /> X HIRED AUTOS (Per accident) <br /> X NON-OWNED AUTOS $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,00 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,00 <br /> B U 8827718 12/31/10 12/31/11 <br /> DEDUCTIBLE $ <br /> X RETENTION $ WC STATU- OTH- <br /> WORKERS COMPENSATION TORY LIMITS X I ER <br /> AND EMPLOYERS'LIABILITY 500,00 <br /> A ANY PROPRIETOR/PARTNERIEXECUTIVE Y C 8827218 01/01/11 01/01/12 E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,00 <br /> If yes,describe under E.L.DISEASE-POLICY LIMIT $ 500,00 <br /> DESCRIPTION OF OPERATIONS below <br /> DESCRIPTION OF OPERATIONS LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Cetifcate holder is additional insured with respects to General Liability <br /> by written contract.Waiver of subrogation applies to General Liability. <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE2 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County <br /> PO Box 8181 <br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE <br /> Pt 54A0VV%fft%4?0%S <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD <br />