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From:919-934-4648 To:9198448339 Page;1/3 Date:811 3/201 2 9;43:49 AM
<br /> CECIL.2 OP ID:SM
<br /> A`CC7JRJa' CERTIFICATE OF LIABILITY INSURANCE DATE 06113OfYYYY)
<br /> 08113/12
<br /> -
<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 poiicy(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 sndoreement(s).
<br /> PRODUCER 919-553-7103 NNAME;
<br /> Triangle Insurance Group,Inc 518-6S3-8TS8 E ram
<br /> PO Box 1179 No,Cot): (AIC,No):
<br /> Clayton,NC 27528 I.UA L
<br /> James H.Nippier,Jr.
<br /> INSURERISS AFFORDING COVERAGE NAIC 0
<br /> INSURER A I Stonewood insurance Company
<br /> INSURED Cecil Holcomb Renovations,Inc INSURER I!Scottsdale Insurance Company
<br /> 8315 LaMatisse Road INSURER C:Colony Insurance Company
<br /> Raleigh,NC 27615
<br /> INSURER DIProgressive Southeastern Ins
<br /> INSURER!:
<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 SE 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 /> INSR ADOL SUER' POLICY EPP POLICY!XP
<br /> LTR TYPE OF INSURANCE BIM NAM POLICY NURSER (MMIDDIYYYYI CMM/OD/YYYYI LIMITS
<br /> GENERAL LIABILITY EACHOCCoURRENCE S 1,000,000
<br /> C X COMMERCIAL GENERAL LIABILITY GL850615 03/21/12 03/21/13 p aIs(Ea 00000urronoo) 5 100,000
<br /> W CLAIMS-MADE I I OCCUR MED EXP Any one potion) S 5,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GENERAL AGGREGATE 5 2,000,000
<br /> OEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGO 5 2,000,000
<br /> A)POLICY n r>RLQT 7 LOC &
<br /> AUTOMOBILE LIABILITY
<br /> COMBINED SINGLE LIMIT 1,000,000
<br /> `_ (Ee eocloentt ....
<br /> D ANY AUTO 067631314 06/11/12 06/11/13 BODILY INJURY(Per person) I
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per encldenl) I
<br /> AUTOS x AUTOS 3
<br /> X HIRED AUTOS X AUTOS ED ( ccICentDAMAGE
<br /> 3
<br /> UMBRELLA LIAR ?( OCCUR EACH OCCURRENCE 3 2,000,000
<br /> B X EXCESmLIAO CLAIMS-MADE XLS0073220 03/21/12 03/21/13 AGGREGATE 3 2,000,000
<br /> utu k NtU EN I ICIN$ 10000 5
<br /> WORKERS COMPENSATION 1 WC STATUU- 10TH.
<br /> AND EMPLOYERS'LIABILITY X J TORY I IMIt'S I ER
<br /> A ANY PROPRIETOR/PARTNERIEXECUTIVE lJ WC10000042232 - 03121/12 03/21/13 E,L,EACH ACCIDENT 3 '1,000,000
<br /> OFFICER/MEMBER EXCLUDED? l_J N/A
<br /> (Mandatory In MN EL DISEASE•EA EMPLOYEE 3 1.000,000
<br /> If yee deeerlx under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE•POLICY LIMIT $ 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ARRAS ACORO 101,AddRlanel Remerb Sohedeb,If mere opines I.required)
<br /> The general liability includes automatic Blanket Additional Insured coverage
<br /> per attached form V156P-0310
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANG20
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange Co.Financial Service ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Dept .
<br /> David E.Cannel/,Purchasing AUTMORKla nlPRlBQRTATIV!
<br /> 200 3.Cameron Street Ar - O�l�/tcbv-e /
<br /> Hillsborough,NC 2727H
<br /> 1
<br /> ®1988.2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/05) The ACORD name end logo are registered marks of ACORD
<br /> Triangle Insurance Group Insurance,Bonds,Employee Benefits
<br />
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