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OWENS-1 OP ID:TL
<br /> CERTIFICATE OF LIABILITY INSURANCE
<br /> DATE
<br /> 10/07/2013Y)
<br /> 10/07/2013
<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 C NTACT
<br /> Senn Dunn-Raleigh Phone:919-719-9570 NAM
<br /> HONE Tammy Coolidge FAx
<br /> 4700 Falls of Neuse Rd,St 190 Fax:919-719-9571 A/c No Ext;919-791-9861 A/C No): 919-372-3716
<br /> Raleigh,NC 27609-2521 AUlilless:tcoolidge@senndunn.com
<br /> AA Benjamin T.Singleton,A
<br /> INSURERS AFFORDING COVERAGE NAIC p
<br /> INSURER A:Builders Premier Insurance Co. 13036
<br /> INSURED Owens Roofing,Inc. INSURER B:Builders Mutual Ins.Co. 10844
<br /> Owens-Hart,LLC INSURER C:
<br /> 301 W.Cabarrus Street
<br /> Raleigh,NC 27601 INSURER D:
<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 /> INSR TYPE OF INSURANCE ADDL UB POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
<br /> A X COMMERCIAL GENERAL LIABILITY PCP000244001 05/01/2013 05/0112014 PREMISES Ea occurrence $ 100,00
<br /> CLAIMS-MADE Fx_1 OCCUR MED EXP(Any one person) $ 5,00
<br /> PERSONAL&ADV INJURY $ 1,000,00
<br /> GENERAL AGGREGATE $ 2,000,00
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00
<br /> POLICY X PRO LOC $
<br /> AUTOMOBILE LIABILITY EOMaBI ED SINGLE LIMIT $ 1,000,00
<br /> A X ANY AUTO PCA000733701 05/01/2013 05101/2014 BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY Per accident $
<br /> AUTOS AUTOS ( )
<br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS Per accident
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,00
<br /> B EXCESS LIAB CLAIMS-MADE UMB002114401 05101/2013 05/01/2014 AGGREGATE $ 4,000,00
<br /> DED X RETENTION$ 1 O OOO $
<br /> WORKERS COMPENSATION X WCSTATU- I JOTH-
<br /> AND EMPLOYERS'LIABILITY YIN I TORY LIMITS I ER
<br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE FN— WCP102219700 01/0112013 01/01/2014 E.L.EACH ACCIDENT $ 1,000,00
<br /> OFFICER/MEMBER EXCLUDED? NIA
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00
<br /> A Intallation COV. PCP000244001 05/0112013 05113/2014 Job Site 1,050,00
<br /> Max Loss 3,150,00
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
<br /> Roof Replacement Battle Court&Court Street Annex, Hillsborough, NC
<br /> Job No. 12-58
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANINS
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> PO Box 8181
<br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE
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<br /> I
<br /> C 1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 26(2010/05) The ACORD name and logo are registered marks of ACORD
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