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186591
<br /> DATE(MM/DD/YYYY)
<br /> AC(:>.R° CERTIFICATE OF LIABILITY INSURANCE
<br /> 6/19/2013
<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 CONTACT Phyllis White
<br /> NAME: y
<br /> Commercial Lines-(919)676-8834 PHONE 919.334.2634 FAX A/C No 919.676.3307
<br /> Wells Fargo Insurance Services USA,Inc. E-MAIL . wesar
<br /> ADDRESS: p h Iliswhite lifo.com y @ g
<br /> 8540 Colonnade Center Drive,Suite 111 INSURERS AFFORDING COVERAGE NAIC#
<br /> Raleigh,NC 27615 INSURERA: Nautilus Insurance Company 17370
<br /> INSURED INSURER B: Great Divide Insurance Company 25224
<br /> Environmental Holdings Group,LLC INSURER C: Hartford Fire Insurance Company 19682
<br /> 190 Kitty Hawk Drive INSURER D: Federal Insurance Company 20281
<br /> INSURER E:
<br /> Morrisville,NC 27560 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 6214716 REVISION NUMBER: See below
<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 /> INSR ryPE OF INSURANCE ADDL SUBR POLICY NUMBER MOL POLICY EFF MM%DDS LIMITS
<br /> LTR
<br /> A GENERAL LIABILITY ECP0150598314 09/30/2012 09/30/2013 EACH OCCURRENCE $ 1,000,000
<br /> DAMAGE TO RENTED
<br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 300,000
<br /> CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,000
<br /> X Contract Pollution PERSONAL&ADV INJURY $ 1,000,000
<br /> X XCU,Contractual GENERAL AGGREGATE $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000
<br /> POLICY X PRO LOC Deductible $ 5,000
<br /> B AUTOMOBILE LIABILITY BAP150598514 9/30/2012 9/30/2013 Ea ecod'ntSINGLE LIMIT 1,000,000
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> NON-OWNED PROPERTY DAMAGE
<br /> X HIRED AUTOS X AUTOS Per accident I $
<br /> $1,000 Comp/Coll Ded. $
<br /> A UMBRELLA LIAB x OCCUR FFX150598614 09/30/2012 09/30/2013 EACH OCCURRENCE $ 10,000,000
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000
<br /> DED I x I RETENTION$ 10,000 $
<br /> WORKERS COMPENSATION X WC STATU- OR
<br /> 1- $0 Retention
<br /> B AND EMPLOYERS'LIABILITY YIN WCA150598414 9/30/2012 9/30/2013 Y LIMITS ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑N NIA
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> C Rented/Leased Equipment 22UUMJC1697 0913012012 09/30/2013 $380,000 each item;$600,000 Total
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
<br /> Project:Orange County Jail
<br /> Orange County Asset Management Services is named as additional insured as respect General Liability if required by written contract.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Orange County Asset Management Services SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> 131 W.Margaret Lane THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 9 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Hillsborough,NC 27278
<br /> AUTHORIZED REPRESENTATIVE
<br /> The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/05)
<br />
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