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<br /> ACCPREI CERTIFICATE OF LIABILITY INSURANCE I DATE,(MIALTONYYTI
<br /> L,..--:---
<br /> 05/17/2012
<br /> PRODUCER
<br /> THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION
<br /> Risk Insurance Management Servioas,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br /> P 0 Box 847 HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
<br /> Holly Springs,NC 27540 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br /> John L Myers,919/552-7278 F: 919/552-5661 1 INSURERS AFFORDING COVERAGE 1 NAIC#
<br /> -------
<br /> iNSURED
<br /> Mackem Construction,LLC I INSURER A: EMC Insurance Companies
<br /> .INSURER B.
<br /> P0 Box 1205
<br /> Carrboro,NC 27510 i INSURER C: _
<br /> ------ —------- _
<br /> INSURER 0:
<br /> INSURER E:
<br /> COVERAGES
<br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING
<br /> ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br /> MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
<br /> POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> JusRiAnot
<br /> I POLICY EFFECTIVE POLICY EiPITIATION
<br /> LTR INDRO TYPE OF INSURANCE POLICY NUMBER
<br /> DATE(MM/DDIYYTY) DATE(MMJOOTfl'Yy14 UNITS
<br /> GENERAL LIABIUTY
<br /> . 05/05/2012 05/05/2013 EACH OCCURRENCE 1$ 1,000,000
<br /> A X COMMERCIAL GENERAL LIABIUTY 403-24-29
<br /> PagiigENTE5 ) I$ 100,000,
<br /> 1 1
<br /> CLAIMS MADE X, ,OCCUR
<br /> MED EXP(Any one person) i$ 5,000
<br /> I
<br /> PERSONAL A.ADV INJURY 15 1,000,000—
<br /> 1_1
<br /> GENERAL AGGREGATE I$ 2,000,000
<br /> ,
<br /> i GERI AGGREGATE LJMIT APPLIES PER
<br /> PRODUCTS-COMP/OP AGO $ 2,000,000
<br /> —.,
<br /> X I POLICY 1',la i---7,...c
<br /> $
<br /> AUTOMOBILE IJABIUTY
<br /> 4E3-24-29 05/05/2012 05/05/2013 COMBINED SINGLE UMIT
<br /> s 1,000,000
<br /> A ANY AUTO (Ea accident)
<br /> _
<br /> ALL OWNED AUTOS
<br /> BODILY INJURY S
<br /> : I SCHEDULED AUTOS (Per person)
<br /> i ,
<br /> I X 1 HIRED AUTOS
<br /> BODILY INJURY $
<br /> NON-OWNED AUTOS (Per accident)
<br /> j PROPERTY DAMAGE 5
<br /> (Per accident)
<br /> GARAGE UABILITY
<br /> AUTO ONLY-EA ACCIDENT 5
<br /> f
<br /> 1 ANY AUTO
<br /> "OTHER THAN EA ACC S
<br /> 1 I AUTO ONLY: Aoc s
<br /> EXCESS!UMBRELLA umaiLmr
<br /> EACH OCCURRENCE 5 —
<br /> OCCUR I 1 CLAIMS MADE AGGREGATE 5
<br /> DEDUCTIBLE
<br /> 5
<br /> —
<br /> RETENTION 5 5
<br /> , I VAC STATU- 0TH-
<br /> WORKERS COMPENSATION AND
<br /> 05/05/2012 05/05/2013 1 X 1 TORY LIMITS R
<br /> A EMPLOYERS'Lutalure
<br /> Y/N 4H3-24-29
<br /> ANY PROPRIETOR/PARTNER/EXECUTIRA VE' N i 1 EL EACH ACCIDENT S 1,000,000
<br /> OFFICEKEMBER EXCLUDED?
<br /> E.L DISEASE-EA EMPLOYEE S 1000,000
<br /> (Mandatory in NH)
<br /> It yes,describe under
<br /> E.L DISEASE-POLICY UMIT 5 1,000,000
<br /> SPFrIAI PROVISIONS beInw
<br /> OTHER
<br /> DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS
<br /> _
<br /> CANCELLATION
<br /> 'CERTIFICATE HOLDER
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION
<br /> Orange County
<br /> DATE THEREOF,THE ISSUING INSURER WILL.ENDEAVOR TO MAIL Y DAYS WRITTEN
<br /> P 0 Box 8181 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
<br /> IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE INSURER.ITS AGENTS OR
<br /> ro
<br /> Hillsbough,NC 27278
<br /> ATTN:Jeff Thompson ijethompson @ co.orange,nc.us
<br /> (:)....•-7.,... -I. T',Alt
<br /> 410,WW
<br /> —.L.,..----
<br /> 0 1988-2009 . 'ORD CORPORATION. All rights reserved.
<br /> ACORD 25(2009(01)
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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