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MUTER -1 OP ID: L1 '4t°RO CERTIFICATE OF LIABILITY INSURANCE YY D 11/112014 ) 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 Senn Dunn - GSO 3625 N. Elm St. NAME: Lindsay C. Frazier, CISR PHONE 336- 346 -1306 A% No): 336- 514 -9416 Alc No Ext E-MAIL ,ss: lfrazier@senndunn.com Greensboro, NC 27455 Russ B. Bell, CIC INSURERS AFFORDING COVERAGE NAIC # INSURER A: Cincinnati Insurance Co. 10677 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR INSURED Muter Construction, LLC John Muter 100 N. Arendell Ave. INSURER 13: Hanover Insurance Group ENP0222614 INSURER c 01/08/2015 DAMAGE TO RENTED PREMISES Ea occurrence $ 10000 Zebulon, NC 27597 INSURER D: PERSONAL & ADV INJURY INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF MM /DD/Y YYY POLICY EXP /Y MM /DDYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR ENP0222614 01/08/2014 01/08/2015 DAMAGE TO RENTED PREMISES Ea occurrence $ 10000 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,00 POLICY X RO ECj P LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1 000 000 $ , , X BODILY INJURY (Per person) $ A ANY AUTO ENP0222614 01/0812014 01/08/2015 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE PER ACCIDENT $ HIRED AUTOS X NON -OWNED AUTOS X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4,000,00 AGGREGATE $ 4,000,00 A EXCESS LIAB CLAIMS -MADE ENP 0222614 01108/2014 01/08/2015 DED I X I RETENTION$ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? F—] (Mandatory in NH) NIA WC2137567 01/08/2014 01/08/2015 X I WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 B Rented /Leased IH6- A096902 -01 09103/2014 09/03/2015 Limit 150,00 Equipment Deductibl 2,50 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Cedar Grove Community Center -Roof Replacement 30 days prior written notice of cancellation shall be provided to the certificate holder except 10 days for non - payment of premium. ORANG16 Orange County PO Box 8181 Hillsborough, NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �"q SW ©1988 -2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD