2013-169 AMS - Ken Moser Company Removal and Replacement of 8 storefront Aluminum & glass Enclosurers at Whitted Building $66,790

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:IPR/30/2013/TUE 07:39 Im A A No, P, 00i KENMO-1 OP ID: K5 T E(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE [ "'DA04/30/2013 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 an this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone;919-556-3698 0N2ANTKcT Karen Brewer Hartsfield&Nash PHONE P.O.afield 1109 Fax:9`19-566-8768 A/c-m.,v,,,:919-556-3698 1(FAOt.N..):919Z58-8758 Wake Forest,NC 27588 ArMss.karengehartsfield-nash.com Don Stroud,CIC,AAI INSURERS)AFFORDING COVERAGE NAIC 6 INSURER A:Cincinnati Insurance Companies 10677 INSURED Ken Moser Company, Inc. wsurER e:First Benefits Insurance Co 3021.8 Stonybrook Drive INSURER C: Raleigh,NC 27604-3783 INSURER D: INSURER E. tNSURFP ,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 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. INS R I ADDL$U5 POLIEY EfF r LTR TYPE OF INSURANCE INSR VMnJ POLICY NUMBER (MMIDDIYYYY) MOM AID LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,00( A X COMMERCIAL GENERAL LIABILITY X EPP01 14258 1210612012 12t0612013 _041Z��t1tNTt:' 1 500,061 PREMISES Me occurrence Fx7OCCUR MED EXP(Any one person) $ 10100( PERSONAL&ADV INJURY $ 1,000,00( GENERALAGGRSGATE $ 2,000,000 GIEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/017 AGG $ 2,000,000 1 1 POLICY I XIM F71LOC SINGLE LIMIT S AUTOMOBILE LIABILITY COMBINED ANY AUTO BODILY INJURY(Per Person) S ALLOWNE"WNED SCHEDULED BODILY INJURY(Per accident) S IUT08 AUTOS NON-OWNED PROPERTY DAMAGE S HIRED AUTOS — AUTOS (Paracciftnt) UMBRELLA UA13 OCCUR EACH OCCURRENCE S EXCESS LLAS HCLAIMS-MADE AGGREGATE 5 DED I I RETENTIONI S WORKERS COMPENSATION X WC STATU- I IOTH- AND EMPLOYERS'LIABILITY YIN I WITS 92. ANY PROPRIETORIPARTNF-RIEXECUTIvE r--1 WC07972013 01/01/2013 01101/2014 E.L.EACH ACCIDENT $ 1,0OFFICER/MEMBER OFFICEREMBER EXCLUDED? I y I MIA mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 1,000,060 tf S,RIPTIQN PERATION$below describe under E.L.DISEASE-POLICY LIMIT S 1,000,000 OF O DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AddltlonaJ Remarks Schedule,If Mom space Is required) Project: Orange County Office Complex (NC) Orange County Go-varnukent is listed as an additional insured with respects to general liability. 30 days notice for cancellation for general liability under form TA.4086. CERTIFICATE HOLDER CANCELLATION OFZAN131 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEt)BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE r)ELIVERED IN Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. f-919-644-3001 131 West Margaret Lane AUTHORIZED REPRESENTATIVE Hillsborough,NC 27278 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010106) The ACORD name and logo are registered Marks of ACORD