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DATE DDI. <br /> MMIDD Y.::::: <br /> :. <br /> IY <br /> Ppot�ucEN ':.:.. . ............................................................:::::::::::::::::::.............................................:.::::::::::::•::::::.::::::::::: ::�Y��< 8 JUL 1996 <br /> 23136 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> 1(!f I I is COrrLon & Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Post Office Box 2166 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Chaps IkH i I I NC 27515-2166 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> (919) 968IA472 <br /> COMPANIES AFFORDING COVERAGE <br /> COMPANY Aetna Casualty and Surety Company <br /> Suzanne Parker A <br /> INSURED COMPANYNC Construction Industry Self-Insurance Fund <br /> Matson Electrical Construction Co. B <br /> P. 0. Box 3105 COMPANY <br /> 1000 Ward Blvd. S. W. C <br /> Wilson NC 27895-3105 COMPANY <br /> D <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 REOUIREMENT,TERMOR CONDITION OF ANYCONTRACT OR OTHER DOCUMENTWITHRESPECT TO WHICHTHIS <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 /> CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR DATE(MM/DD/YY) DATE.(MM/DD/YY) LIMITS <br /> GENERAL LIABILITY GENERAL AGGREGATE $ 3,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 3,000,000 <br /> A CLAIMS MADE OCCUR 025CO025211384CCA 01-MAR-1996 01-MAR-1997 PERSONAL & ADV INJURY $ 1,000,000 <br /> OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 <br /> FIRE DAMAGE(Any one fire) $ 100,000 <br /> MED EXP (Any one person) $ 5,000 <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ 1,000,000 <br /> X ANY AUTO <br /> A ALL OWNED AUTOS 025FJ1080238CCM 01-MAR-1996 01-MAR-1997 BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS <br /> BODILY INJURY $ <br /> X NON-OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN AUTO ONLY: <br /> EACH ACCIDENT $ <br /> AGGREGATE $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> UMBRELLA FORM AGGREGATE $ <br /> OTHER THAN UMBRELLA FORM g <br /> WORKERS COMPENSATION AND X WC STATUI 0 H- <br /> EMPLOYERS'LIABILR <br /> B Y 69 01-JUL-1996 30-JUN-1997 EL EACH ACCIDENT $ 100,000 <br /> THE PROPRIETOR/ X INCL EL DISEASE-POLICY LIMIT $ 500,000 <br /> PARTNERS/EXECUTIVE <br /> OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONSA.00ATIONS/VEHICLES/SPECIAL ITEMS <br /> SEE ATTACHED <br /> D......................................... ..........:::::::::;:.;:.;:;;:.;:.;:<;<;;<;<:<::::.:;.;;:.;:.;:.;:<.;::«.;::;•��lN(��4!«l►..i�3�>::>:<:>Exae Y:::t:O::D . :.;.or.:.Nan..: . . <br /> d4HS�l(�ilH4Y�il��xi4���i �?lif�'J�1VI �Xif�Sl��fxi6?i�f� <br /> xxxxxx>bly�tiWe'IfEif�fXl4 >(iSxi4Y�24L�1f�ilP fKXi�YefiLiiXK�i(��FL <br /> County of Orange d4� (If20FIf��i2WililtlfXltlfVWllf lllfXlSlS�fifiWH(l 11<iflSWllflSlfRSlllf�f2iXlf (i�% <br /> 132 East King Street wx x ( is (x (x x xllL��IfIE�L�if�fXi�lf <br /> Hillsborough NC 27278 71Z <br /> REP...... .N..T..A..T.../..... <br /> . ..::::::::::::.::::.::: ::::.:::::::::::::::::::::::::::: ................... . <br /> ................................. <br /> It Elt. 1. <br />