2012-169 EDC - Buxton Corporation for Analysis Services $56,000

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, r Client#:66735 18BUXTOCOM ACORIX CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYY)6/29/2012 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 CONTACT NAME: Wortham Insurance&Risk Mgt PHONE 817 336-3030 FAX 817-336-8257 1600 West Seventh Street E(NC, L Est): (A/C,No): ADDRESS: Fort Worth,TX 76102-2505 817 336-3030 INSURER(S)AFFORDING COVERAGE NAIL N INSURERA:Valley Forge Insurance Company 20508 INSURED INSURER B:Continental Casualty Company 20443 Buxton Company INSURER C:National Fire Insurance Co of H 20478 2651 S.Polaris Drive Fort Worth,TX 76137 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 1 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 TYPE OF INSURANCE ADDLSUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER _JMM/DD/YYYYUMM/DD/YYYY) A GENERAL LIABILITY P2093358583 07/13/2011 07/13/2012 EEACCH�OCCCpURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES(EaEoNOrTEg nce) $300,000 CLAIMS-MADE X OCCUR MED EXP(My one person) $5,000 PERSONAL 8 ADV INJURY $1,000,000 _ GENERAL AGGREGATE 52,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 TiPOLICY ZS-ZST n LOC _ $ C AUTOMOBILE LIABILITY P1079708301 07/13/2011 07/13/201 (ECOMa accidBINED ent)SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS AUTOS (Per accident) $ B UMBRELLA LIAB _ OCCUR P2093460191 07/13/2011 07/13/2012 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED I XI RETENTION$10,000 $ A WORKERS COMPENSATION WC2093007771 05/03/2011 05/03/2012 X I ORYTLIMITS ERH AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 51,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) BLANKET CG 2010(G-300693-A)G56015B1191 Additional Insured Owners,Lessees or Contractors-Scheduled Person or Organization CG20100704 Texas Additional Insured CA04030604 CERTIFICATE HOLDER CANCELLATION ANY OF THE Orange County Economic THE SHOULD EXPIRATION DATE V THEREOF,E NOT CEI WILL CBE GDELIVERED NE Development ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1177 131 W.Margaret Lane-Ste 205 AUTHORIZED REPRESENTATIVE Hillsborough, NC 27278 1 0440•t-IG •..]t,-.j u.a.—..,/ ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S315502/M280386 18KMA