2015-182-E DEAPR - Eastern Turf Maintenance, Inc. for field maintenance $1,800

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DocuSign Envelope ID: 19E15DDF-63D4-408F-A759-D7535DECD3BE A�°R°® CERTIFICATE OF LIABILITY INSURANCE D `YYYY' 4//8/28/2W°D015 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(tes) 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 CONTACT NAME• Patty Miller Business Insurers of Carolinas PHONE (919)968-9611 0,(919)968-8991 800 Eastowne Drive, Suite 208 eiDOlss:pom @business-insurers.com PO BOX 2536 INSURERS AFFORDING COVERAGE NAIC# Chapel Hill NC 27515-2536 rNSURERA EmcaSOO 21407 INSURED INSURER B�m to exs Mutual Casualty 1415 Eastern Turf Maintenance Inc. INSURERC: 3305 Anvil Place 1NSURERD: INSURER E: Raleigh NC 27603 INSURER F: COVERAGES CERTIFICATE NUMBER:2015-2016 REVISION NIUMBER; 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 OTHE=R DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PFRTAtN, 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 ADOL SUBR LTR TYPE OF INSURANCE POLICY NUMBER POLICY DD!YYYY MM DDf EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence S 100,000 A CLAIMS-MADE OCCUR D67716 /k5/20i5 /15/2016 MED EXP(Any one person) S 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM Plop AGO S 2,000,000 X POLICY X PRO LOC $ AUTOMOBILE LIABILITY EO$BST ED SINGLE LIMIT 1,000,000 A JX ANY AUTO BODILY INJURY(Perperson) $ ALL AUTOSMEO X AV CHED OSUL>=D E67716 /15/2015 /15/2016 BODILYINJURY(Peraccident) S HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Were ccident) $ Undednsuredmolodst $ 1,000,000. X UMBRELLALIAB X I OCCUR ollows form Auto,GL,WC EACH OCCURRENCE s 1,000,000 A EXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 OED I X I RETENTIONS 10100 J67716 /15/2015 /15/2016 S * WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS`LIABILITY YIN tip ER ANY PROPMETCR1PARTNERIEXECLITIVE E.L.EACH ACCIDENT $ 1 000 000 ED? OFFICERIMEMBER EXCLUD MIA (Mandatory In NH) 4H67716 /15/2015 /15/2016 I E L DISEASE-EA EMPLOYE $ 1,000,000 tpes,describe under DESCRIPTION OF OPERATIONS below ---- E.L.DISEASE-POLICY LIMIT $ 1 000,000 8 Leased/Rented Equipment 4C67716 /15/2015 /15/2016 $25,000ACV $500 deduct DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) RE; Fairview Park Baseball Field I CERTIFICATE HOLDER CANCELLATION 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 Patty Miller/PATTY 6�g- ACORD 26(2010/05) ©1988-2010 ACORD CORPORATION. All rights roserved. INS025ontnnsi m Tho Ar1r1Rr]nama and Inrrn ara ranicfarorl mnrke of Ar-r1Rr1