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RIGGS-2 OP ID: MA
<br /> ACORD- CERTIFICATE OF LIABILITY INSURANCE
<br /> DATE 0512 312 0 1 Y1�
<br /> 05123!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
<br /> TriSure Corporation-HS PHONE MelanieA1949 ton FAx
<br /> 4325 Lake Boone Trail AIC No Ex t):919-388-1949 AIC,No): 919.467-4987
<br /> Suite zoo AD
<br /> Raleigh, NC 27607 DRESS:mairington@trisure.com
<br /> Smelcer&Associates INSURER(S)AFFORDING COVERAGE NAIC s
<br /> INSURERA:Selective Ins.Co.of America 12572
<br /> INSURED Riggs-Harrod Builders Inc. INSURER B:Builders Mutual Insurance 10844
<br /> PO BOX 11100
<br /> Durham, NC 27703 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 LTR TYPE OF INSURANCE POLICY NUMBER WDD MMIDD LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
<br /> A kCOMMERCIAL GENERAL LIABILITY X $2002862 10/31!2013 10/31/2014 PREMISES(Ea occurrence) $ 100,00
<br /> CLAIMS-MADE Fx—1 OCCUR MED EXP(Any one person) $ 10,00
<br /> PERSONAL&ADV INJURY $ 1,000,00
<br /> GENERAL AGGREGATE $ 2,000,00
<br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO $ 2,000,00
<br /> POLICY X PEO- LOC Emp Ben. $ 1,000,00
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> (Ea accident) 1,000,00
<br /> A X ANY AUTO X S2002862 10/31/2013 10/31/2014 BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED
<br /> AUTOS AUTO BODILY INJURY(Per accident) $
<br /> X NON-OWNED (ERPDENj GE
<br /> HIRED AUTOS X UTOS PACC $
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,00
<br /> A EXCESS LIAB CLAIMS-MADE X 52002862 10/31/2013 10/31/2014 AGGREGATE $ 6,000,00
<br /> DED I X I RETENTION $ $
<br /> WORKERS COMPENSATION X WC STATU- OTH-
<br /> AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER
<br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE X PWC1009951 10/31/2013 10/31/2014 E.L.EACH ACCIDENT $ 1,000,00
<br /> OFFICER lMEMBER EXCLUDED? NIA --- ----
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00
<br /> If yes,describe Under
<br /> DESCRIPTION OF OPERATIONS below I I I E.L.DISEASE-POLICY LIMIT $ 1,000,00
<br /> A Leased/Rented S2002862 1013112013 10/31/2014 Limit 100,00
<br /> A Builders Risk S2048827 10/3112013 10/31/2014 Limit 10,000,00
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
<br /> Project: Sportsplex Lobby -Renovatons
<br /> Bid # 367-294
<br /> Orange County Government(Owner) , the Designer, the Designers's consultants,
<br /> andthe construction manager are listed as additional insureds with respect
<br /> to General Liability, Auto liability and umbrella liability on a
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORA8181
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> a County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED, IN
<br /> Oran
<br /> g ty ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> P O Box 8181
<br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE
<br /> O 1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
<br />
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