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<br /> From:919-934-4648 To:9198448339 Page: 1/3 Date: 8/13/2012 9:43:49 AM
<br /> �r1 CECIL•2 OP ID:SM
<br /> AIC°R°+ CERTIFICATE OF LIABILITY INSURANCE PATE(MMIDDIYYYY)
<br /> 06113/12
<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 DOER 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 /> PRODUCER 919-663-7103 UVT
<br /> Triangle Insurance Group,Inc 919-553-6759 PHONE FAX
<br /> PO BOX 1170 C Ir�Set): (A G,No):
<br /> Clayton,NC 27525 ADORESSI
<br /> James H.Nappier,Jr. IN5URERI$l AFFORDING COVERAGE ERIC!,
<br /> Mugu AIStonewood Insurance Company
<br /> INSURED Cecil Holcomb Renovations,Inc INSURERe:Scott$dale Insurance Company
<br /> 8315 LaMatlsse Road INeunec:Colony Insurance Company
<br /> Raleigh,NC 27615
<br /> muesli Progressive Southeastern Ins
<br /> INSURER E
<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 /> INER AOOL tUBR POLICY EPP I POLICY EXP
<br /> LTR TYPE OF INSURANCE *AR (MVO POLICY NUMBER - IMSIDIXTYM.1(MMlODLTYr'1 LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
<br /> C X COMMERCIAL GENERAL LIASILRY 01.650615 03/21/12 03/21/13 D ASE R
<br /> PRE M8E3(TO Ea ENTED ooeurtenoal s 100,000
<br /> CLAIMS•MADE I X I OCCUR MED EXP(Arry one pawn) $ 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000_
<br /> GENERAL AGGREGATE S 2,000,000
<br /> OEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/0P AGO E 2,000,000
<br /> X POLICY 7 jp$T LOC t
<br /> AIJ?OMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> EEe eccloen11 ! 1,000,000
<br /> o ANY AUTO 067631314 05)11/12 06111/13 BODILY INJURY(Per person) S
<br /> ALL OWNED x AUTOS SCHELED BODILY INJURY(Par socdarrt) $
<br /> AUTOS DU
<br /> X HIRED AUTOS X NON.DWNED PROPE3YV DAMAGE
<br /> nU S
<br /> AUTOS (PerecCe
<br /> U
<br /> rr
<br /> UMBRELLA LIAR X OCCUR EACH OCCURRENCE a 2,000,000
<br /> —
<br /> B X EXCESS LIAO CLAIMS-MADE XLS0073220 03121/12 03/21/13 AGGREGATE $ 2,000,000
<br /> utu X HtIL:NIIUNI 10000 OER.
<br /> $
<br /> WORKERS COMPENSATION J
<br /> X I W 5FAMITS
<br /> AND EMPLOYERS'LIAB(LJTY
<br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE Y l M WC10000042232 03121/12 03/21/13 EL EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N IA
<br /> (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $ 1.000,000
<br /> II yea,delniEe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT S 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Altash ACORD 101,Addlelansl Remarks Schedule,Umsre apses I■required)
<br /> The general liability includes automatic Blanket Additional Insured coverage
<br /> per attached form U156P-0310
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANG20
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange CO,Financial Service THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Dept ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> David E.Cannell, Purchasing
<br /> AUTHORIZES llepRRBeR1ATlve
<br /> 200 S.Cameron Street
<br /> H SAG ii 4x1)44
<br /> Hillsborough,,N NC 27278
<br /> ' I _
<br /> ®1965.2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/06) The ACORD name and logo are registered marks of ACORD
<br /> Triangle Insurance Group Insurance,Bonds, Employee Benefits
<br />
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