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JFWIL-1 OP ID:CL
<br /> 4COR0" DATE(MMIDDIYYYY)
<br /> �...�- CERTIFICATE OF LIABILITY INSURANCE 07108/2014
<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 WANED, 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 /> NAME: Cath Lucas,AAI.
<br /> Summers Thompson Lowry,Inc. PHONE FAX,
<br /> 100 Europa Drive,Suite 571 c No Ex t):919-969-5311 c;No: 919-942-4221
<br /> Chapel Hill, NC 27517 ADDRESS:cathy@stlinsure.com
<br /> C.Duke Thompson CPCU ARM
<br /> INSURERS)"AFFORDING-COVERAGE NAIL*
<br /> INSURERA:Travelers Property Casualty 25674
<br /> INSURED J.F.Wilkerson Contracting Co.: INSURER B:Builders Mutual.Insurance Co.
<br /> Inc.,
<br /> P.O:Box 183 INSURERC:Travelers indemnity Co.. 2565$
<br /> Morrisville,NC 27560 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 /> L7R. TYPE OF INSURANCE POLICY NUMBER' MMIDD (MMIDDIYYYYI LIMITS
<br /> GENERAL LIABILITY
<br /> EACH OCCURRENCE $ 1,000,00
<br /> A X COMMERCIAL.GENERAL LIABILITY X C0613354615 04101/2014 0470172015 PREMISES Ea occurrence $ 300,000
<br /> CLAIMS-MADE �OCCUR MED EXP(Any one person) $ 10,000
<br /> ' PERSONAL&ADV INJURY $ 1,000,00
<br /> GENERAL AGGREGATE $ 2,000,00
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00
<br /> ' POLICY X JECT LOC pid ded $ 2,500
<br /> AUTOMOBILE LIABILITY COMBINED.SINGLE LIMIT
<br /> (Ea accident) $ 1.,000,00.
<br /> C Ix ANY AUTO 81068354615 04/0172014 04/01/2015 BODILY INJURY(Per person) $
<br /> AUTOS�ED ALTOS SCHEDULED BODILYINJURY(Paraccident) $
<br /> YNEp PROPERTY DAMAGE AUTOS HIRED AUTOS X AU PER ACCIDENT
<br /> $
<br /> X UMBRELLALIAB. I X OCCUR EACH OCCURRENCE $ .6,000,00
<br /> ' C EXCESS LIAB CLAIMS-MADE CU.P613354615 0410112014 04/0112015 AGGREGATE $ 6,000,00
<br /> .DED I X I RETENTION 10,000 prod/comp $ 6,000,00
<br /> WORKERS.COMPENSATION WC STATU-AND EMPLOYERS'EMPLOYERS'
<br /> LIABILITY YIN X TORY LIMITS ER
<br /> B ANYPROPRIETORIPARTNER/EXECUIIVE CP101769702 04/01/2014 04/0112015 E.L.EACH ACCIDENT $ 5500,000
<br /> ' OFFICERIMEMBER EXCLUDED? NIA
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 5500;000
<br /> Ifyes,describe under
<br /> DESCRIPTION.OF OPERATIONS below. E.L.DISEASE-POLICY LIMIT $ 5500,000
<br /> A Contractor equip 6606B715799 04/0172014 04/0112015 leased 100,000
<br /> ' ded 2,500
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Attach ACORD 101,:Additional Remarks Schedule;If more space Is required)
<br /> Project: Morinaga America Foods, Inc. Facility Infrastructure Improvements,
<br /> Orange County, NC,
<br /> Blanket additional insured end't applies to general liability as rern,;redby
<br /> written contract. We can not guarantee that the insured will carry insurance
<br /> for two years after completion of the project. That is the insured's
<br /> ' CERTIFICATE HOLDER CANCELLATION
<br /> ORANGE1
<br /> ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF; NOTICE WILL BE DELIVERED IN
<br /> Orange County(owner.) ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 200 S.Cameron St AUTHORIZED IV
<br /> Hillsborough,NC 27278
<br /> 1 c
<br /> 9-1 9L
<br /> 0.1988-2010 ACORD`CORPORATION. All rights reserved.
<br /> ACORD 25(2010105)' The ACORD name and logo are registered marks of ACORD
<br />
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