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OLIVE-3 OP ID: MG <br /> CERTIFICATE OF LIABILITY INSURANCE DA06/06/201 V) <br /> 06/06/2014 <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 <br /> Thompson-Allen,Inc. NAME: <br /> P.O.Box 100 PHONE FAX <br /> A/C No Ext: A/C No): <br /> Roxboro,NC 27573 E-MAIL <br /> Marcia D.Green ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Cincinnati Indemnity Company 23280 <br /> INSURED Olive Hill Welding and <br /> 1940 Semora Rd. INSURERB:Cincinnati Insurance Company 10677 <br /> Roxboro, NC 27574 INSURER C: <br /> 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 <br /> LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> INRR GENERAL LIABILITY <br /> EACH OCCURRENCE $ 1,000,00 <br /> B X COMMERCIAL GENERAL LIABILITY CAP 5133608 07/06/2013 07/06/2014 PREMISES Ea occurrence $ 100,000 <br /> CLAIMS-MADE a OCCUR MED EXP(Any one person) $ 5,00 <br /> PERSONAL&ADV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,00 <br /> POLICY F PRO LOC $ <br /> AOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident) $ 1,000,00 <br /> B CAA 5133608 07106/2013 07/06/2014 BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY Per accident $ <br /> AUTOS AUTOS ( ) <br /> NON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS PER ACCIDENT $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE WC1872846-00 07/06/2013 07/06/2014 E.L.EACH ACCIDENT $ 500,000 <br /> OFFICER/MEMBER EXCLUDED? [7 N/A <br /> (Mandatory in NH) <br /> If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 500,00 <br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I $ 500,00 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGCS <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Curt Farmer <br /> 200 South Cameron Street AUTHORIZED REPRESENTATIVE <br /> Hillsborough, NC 27278 Marcia D. Green <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD <br />