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DocuSign Envelope ID:460EC398-6CEE-4CAF-831A-1D646823727C <br /> Ac°® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) <br /> L--� 09/16/2014 <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 /> :LOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> PRESENTATIVE 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 /> NAME; <br /> Compare Insurance Agency LLC PHON E (919) 863-0150 Fax <br /> A/C No l:(919) 063-0156 <br /> 6531 Cl_eedmoor Rd Suite 206 E oalLS .iliana @compareins.org <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> Raleigh NC 27613- INSURER A-Harf ord Mutual Insurance 14141 <br /> INSURED Cruz Concrete Experts LLC INSURERS., <br /> 800 Linens St INSURER C; <br /> INSURER 0: <br /> INSURER E <br /> Graham NC 27253— 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 ADDLSUBR POLICY EFF. POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/Y YYYJ (MMIDONYYYJ LIMITS <br /> A GENERALLIABILITY 9110413 0/04/2013 0/04/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE15- <br /> ImMMERCIAL GENERAL LIABILITY / / / J PREMISES Ea occurrence $ 100,000 <br /> CLAIMS-MADE Fx-1 OCCUR / / / / MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY S 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: / / / / PRODUCTS-COMP/OPAGG $ 2,000;000 <br /> POLICY rx-1 PRO LOC J / / / $ <br /> / J / / MBINED SINGLE LIMIT <br /> AUTOMOBILE LIABILITY <br /> Co accident <br /> ANY AUTO / / / / BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED / / / / BODILY INJURY(Per accident) $ <br /> AUTOS NON-OWNED / J / / PROP $ <br /> HIRED AUTOS AUTOS Per..E DAMAGE <br /> ident <br /> UMBRELLA LIAB HOCCUR J / / J EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE / / / / AGGREGATE S <br /> DED I I RETENTION$ / / / / S <br /> A WORKERS COMPENSATION 4020413 0/04/2013 0/04/2014 X WCSTATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y/N �' ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE / / / J E.L EACH ACCIDENT 1 $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory in NH) E.LDISEASE-EAEMPLOYE $ 1,000,000 <br /> If yes describe under <br /> DESCRIPTION OF OPERATIONS below J / / J E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) <br /> ATTN. TAMMY <br /> CERTIFICATE HOLDER CANCELLATION <br /> ( ) - (919) 644-3001 <br /> tcomar@orangecountync.gov SHOULD ANY OF THE ABOVE DESCRIBE POLI IES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, OTIC WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PRO ISIONS <br /> Orange County <br /> PO BOX 8181 AUTHO IZE RE SENTATIVE <br /> Hillsboro NC 27278- <br /> ACORD 25(2010/05) 8• 0 ACORD CORPORATION. All rights "reserved. <br /> INS026(201005).01 The ACORD name and logo are registered marks of ACORD <br />