2014-213 Planning - Pilot Environmental Inc. for environmental services $31,650

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A °R°® CERTIFICATE OF LIABILITY INSURANCE 5i2i2014) 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 NAMEA r Jeff Edmonds NAME: Chappell Insurance Agency, Inc. PHONE (336)356-8087 AIC No):(336)356-9153 209 S Main Street E-MAIL eff @cha ellinsurancea enc corn ADDRE S:i PP 3 y PO BOX 829 INSURER(S)AFFORDING COVERAGE NAIC# Dobson NC 27017 INSURERAAdmiral Insurance Company 4856 INSURED INSURERS Hartford Underwriters Insuranc Pilot Environmental, Inc. INSURERC: PO BOX 128 INSURER 0: INSURER E: Kernersville NC 27285 1 INSURER F: COVERAGES CERTIFICATE NUMBER:CL145201095 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. INTR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP S POLICY NUMBER MMlot) W MM/DDlYYYY I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGES( RENTED PREMISES Ea occurrence $ 50,000 A CLAIMS-MADE FX OCCUR EI-ECC-19347-00 4/17/2014 4/17/2015 IVIED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 X I POLICY PRO- LOC $ AUTOMOBILE LIABILITY EOa BINEDtSINGLE LIMIT $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED EI-ECC-19347-00 4/17/2014 4/17/2015 BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS per accident UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ NIA (Mandatory in NH) ID#12644-00100 /17/2014 4/17/2015 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Professional Liability EI-ECC-19347-00 4/17/2014 4/17/2015 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION abpittman@ orangecountync.g SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Planning Department ACCORDANCE WITH THE POLICY PROVISIONS. Abigaile Pittman 131 W Margaret Lane AUTHORIZED REPRESENTATIVE Suite 201 Hillsborough, NC 27278 c _ Jeff Edmonds/JE1 ca ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 t9ninnF1 nt The Ar npn nnmc anrf Inn^nrn rnnicfnrorf markc of arniz l