2014-115 AMS - Hillsborough Plumbing, Inc. for installation of break sink and casework at Whitted Bldg.

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® DATE(MMIDDIY AC v CERTIFICATE OF LIABILITY INSURANCE 12/10/2013 13 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 on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Colonial Insurance Agency Hillsborough PHONE (919)732-2191 a/c o:(919)732-2192 E- A MAIL DRES PO BOX 490 INSURER(S)AFFORDING COVERAGE NAIC# HILLSBOROUGH NC 27278 INSURER 40wners Insurance Company 2700 INSURED INSURER B: Hillsborough Plumbing Company Inc INSURERC: 1020 Nc Highway 57 INSURER D: INSURER E: Hillsborou h NC 27278-8987 INSURER F: COVERAGES CERTIFICATE NUMBER-CL1392700097 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. INSR ADUL15UUKI POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIMIYYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 ENTED X COMMERCIAL GENERAL LIABILITY PREMISE T R occurrence $ 300,000 A CLAIMS-MADE Fx_1 OCCUR 35256947 /14/2013 /14/2014 M ED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED dnt SINGLE LIMIT 11000,000 Ix ANY AUTO BODILY INJURY(Per person) $ A ALLOWNED SCHEDULED 725694701 /14/2013 /14/2014 BODILYINJURY(Peraccident) $ AUTOS AUTOS $HIRED AUTOS X AUTOS EO PROPERTY rraccidentDAMAGE Uninsured/Underinsured $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTION$ 725694700 /14/2013 /14/2014 $ A WORKERS COMPENSATION WCs LIMIT OH- S I EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1 000,000 OFFICER/MEMBER EXCLUDED? 5041871 /14/2013 /14/2014 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,desaibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 A Leased or Rented 35256947 /14/2013 /14/2014 50,000 Equipment I IS DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,N more space is required) Certificate holder is additional insured with respects to General Liability by written contract for project: R.W. Whitted Building 300 Tryon Rd Hillsborough-Break Sink and Casework Install. Waiver of Subrogation applies to Workers Compensation. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE CARLA MOORE/CARLA � r�/�' _ i"7•�� ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. IN9025 nm onsi ni The AnnRr1 name and Inn^and rania+ara'I marka of Arnspn