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ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> TM 06/04/2013
<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 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 NA ME. Faison
<br /> Wade S. Dunbar Agency, Inc. (A/C.o Ext: 919.532.3131 (AIC,No):919.532.3130
<br /> 7951 Monument Lane, Ste 120 - IL
<br /> ADDRESS:
<br /> Raleigh, NC 27615 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA: Union Insurance Company 25844
<br /> INSURED L A Downey & Son, Inc. INSURERB: Great American Insurance Company
<br /> PO Box 1688 INSURER C: Rockhill Insurance Company
<br /> Durham, NC 27702-1688 INSURERD: Firemen's Insurance Company of Washington I
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 12/13 Master w/ 13-14 WC 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 /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD (MMIDD/MY) LIMITS
<br /> GENERAL LIABILITY CPA01258304 08/31/2012 08/31/2013 EACH OCCURRENCE $ 1,000,00
<br /> X COMMERCIAL GENERAL LIABILITY $0 DE PREMISES(Ea occurrence) $ 100,000
<br /> CLAIMS-MADE FX] OCCUR MED EXP(Any one person) $ 10,000
<br /> A X Pollution Li abi 1 i t RCPLE0039210 05127/2013 05/27/2014 PERSONAL&ADV INJURY $ 1,000,000
<br /> X Rockhill Insurance GEN AGG: $4,000,00 GENERAL AGGREGATE $ 2,000,00
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: EA CON POLLUTION LM PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> POLICY JEOT LOC $4,000,00 $L)SINGLE LIMI 1 AUTOMOBILE LIABILITY CAA01258294 08/31/2012 08/31/2013 (Ea accident) $ 1,000,00
<br /> X ANY AUTO $250/$500 DE BODILY INJURY(Per person) $
<br /> A ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> NON-OWNED DAMAGE $
<br /> HIRED AUTOS X AUTOS (Per accident)
<br /> X UMBRELLA LIAB Al OCCUR CPA0125830 08/31/2012 08131/2013 EACH OCCURRENCE $ 6,000,00
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 6,000,000
<br /> DDIED X RETENTION$ $
<br /> WORKERS COMPENSATION WCA425171 01/07/2013 01/07/2014
<br /> AND EMPLOYERS'LIABILITY TORY LIMITS ER
<br /> A
<br /> F ANY PROPRIETOR/PARTNERIEXECUTIV�Y/N $0 DE E.L.EACH ACCIDENT $ 11000,000
<br /> D OFFICERIMEMBER EXCLUDED? U N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> Build Risk/Inst Floater IMP17854831 12/01/2012 12/01/2013 $1,000,000 per location
<br /> B Leased/Rented Equipment $200,000 any one occurrence
<br /> $1,000 Ded
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
<br /> roject: R E Whitted Building: Stormwater Repairs
<br /> sset Management Services and Orange County are listed as additional insured on the general liability
<br /> and auto liability policy. A 30 day written notice of cancellation will be given to the certificate
<br /> older except for 10 day notice of nonpayment of premium.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Asset Management Services AUTHORIZED REPRESENTATIVE
<br /> 131 W Margaret Lane �G
<br /> Hillsborough, NC 27278 Scott Trachtenberg/BF
<br /> ©1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
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