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<br />~ CERT~FICATE a'F LiABILITY INSURANCE '~DATEFMMlDDI'YYYY} ~
<br /> o2127112
<br />7HIS CER7IFICATE IS 1SSUED AS A MATTER OF lN'FORMATION ONLY ,t1ND CONFERS NO RIG}~fTS IJPpN THE CERTIFICATE HOLDER. THIS
<br />CERTfFICATE DOES NOT AFFIRlVIATIVELY OR NEGATiVELY AMEND, EXTEND OR ALTER THE COVERAGE AEFORDED BY THE POLIGdES
<br />BELOW. 7H1S CERTIFlCATE OF lNSURANCE DOES NOT GONSTITUTE A CONTRACT BE7WEElrf THE ISSU]NG INStIF2ER(Sa, AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CER7IFICATE HOLDER:
<br />IMPORTANT: If the ce~tifieate holder is an ADDITIONAL INSURED, the po~icy(ies} must be endorsed. If SUBROGATIQN iS WAIVED, subject to
<br />Ihe term5 and condltions of the poflCy, Cert~ln policies may reqvire an endorsement. A statement on this certificate does not confer rights to the
<br />certificate ho-der in lieu of such endorsemEnt s}.
<br />PROOUCeR 949~71~~22
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<br />Tyson Insurance S
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<br />P. ^ BOX 15734 E.MAII .`
<br />Durham, NC 27704- ADi7RESS _ ._- . ------_ _ -..... __-r--._..
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<br />~N$URED grown Brothers Plumbing 8~ ___. _:__.. _....--
<br />~r,su~E~A:Builders Mutual Insurance Co.
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<br />Heating Company _. _~. ...T. _ .. ..~._r._,,. ..__..__ . :._ : .. . --
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<br />2820 N, Roxboro Rva~l ~NSURER6
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<br />Durham, NC 27704 ir~sueeR c: :. .
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<br />TMIS IS TO'CERTfFY THAT TME POLfCIES OF INSURANCE USTED BEL~W HAVE BEEN ISSUED T0 TH'E INSURED NAMED ABqVE FpR THE POLfCY P~RtOD
<br />INDICATED NOTW17HSTANDfNG ANY REQUIREMENT, TERM OR GQNp1710N OF ANY CONTRRCT OR OTHER DOCUMENT WITH RE5PEGT TO WNICH THIS
<br />CER7IFICA7E MAY BE ISSUED OR MAY PERTAIN, THE INSURAfvCE AFFORDED BY THE POLICfES DESGRIB~D HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSFONS ANR CONpITIONS OF SUCH POUCIES; LIMITS SHOWN MAY HAVE ~EEN REQUGEO BY PAID CLAIMS.
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<br />' ~ EACId OCCURRENCE $ 'I,OOO,OOO
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<br />. DFSGR1PTiON Of~OP@RATIONS below
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<br />q Equipment; Leased ~ PCPOtl00055 03 12/31111 12/31/1~ Equipment 250,00
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<br />DESCR~PTION OF Op~RA7lONS ILOCATIONS / VEHICLES (Attacfi ACORD t01, Adtlkianal Remarks Schedule, fi more space is requfr¢d)
<br />Joh: drange County Jaif
<br />Orange Gounty, North Carolina (owner) is additional insured per the attached
<br />forms.
<br />GERTIFICA7E HOLI]ER re~r_~~ i eTinu
<br />ORANC07
<br /> SHOULD ANY OF TNE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERE4 IN
<br />Attni Frartk W. GliRbn, Mgr. ACCQRDANGE WITH 7HE FOLICY PROVISIONS.
<br />ZOO~S. G8fT1~eTOt1 St:
<br />P.O~. BQX S'IS'I ~-
<br />Hiltsboraugh,NC 27278 AUTHORIZED R€PRE5ENTATIVE t ~ ~ ~?
<br />Diane S. Long ~
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<br />~O 998~-2009 ACORD CORPORATION. All rights reserved.
<br />ACf3RD 2S (2009/Q9) 7he ACORD name a~d logo are registered marks of ACORb
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