2015-118 AMS - Muter Construction LLC for Cedar Grove Community Center Roof Replacement

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MUTER-1 OP ID:TI ' CERTIFICATE OF LIABILITY INSURANCE IY DATE(MM/DDYYY) 01/13/2015 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 endorsements). PRODUCER CONTACT Senn Dunn-GSO NAME: Lindsa C.Frazier,CISR 3625 N.Elm St aCCC, ,d:336-272-7161 FAX No): 336-514-9416 Greensboro,NC 27455 E-MAIL ADD Pressley A-Ridgill,Jr. s:ifrazier senndunn.COm INSURERS AFFORDING COVERAGE NAIC# INSURER A:Cincinnati Insurance Co. 10677 INSURED Muter Construction,LLC - INSURER B:Hanover Insurance Group John Muter 100 N.Arendell Ave INSURER C: Zebulon,NC 27597 INSURER D: 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. IL7RR TYPE OF INSURANCE L 5 B POLICY NUMBER MM/DD EFF fNMIDCD EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY ENP 0222614 0110812015 01/08/2016 PRREM SES Ea occurrence $ 100,00 CLAIMS-MADE I—XI OCCUR 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 PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 A X ANY AUTO ENP 0222614 01/0812015 01/0812016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ rAUTOS PER ACCIDEN X UMBRELLALJAB X OCCUR EACH OCCURRENCE $ 5,000,00 A EXCESS LIAB CLAIMS-MADE ENP 0222614 01/08/2015 01/0812016 AGGREGATE $ 5,000,00 DED RETENTION$ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN L A ANY PROPRIETOR/PARTNER/EXECUTIVE F—] WC 2137567 0110812015 01108/2016 E. EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 B Leased/Rented IH6-A096902-01 09103/2014 09/0312015 Limit 150,00 Equipment Ded 2,50 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: Cedar Grove Community Center-Roof Replacement Orange County is additional insured with respects to General Liability arising from the operations of the Named Insured as required with written contract. 30 days prior written notice of cancellation except 10 day nonpayment of premium is required to the certificate holder. CERTIFICATE HOLDER CANCELLATION ORANG16 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, ,NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD