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DocuSign Envelope ID:622E9DC1-8F03-4B1 C-AA8A-1 1 C1D46D7FEA
<br /> ----s DATE:("'iDI NYYYi
<br /> CERTIFICATE OF LIABILITY INSURANCE-' 1262212014
<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)i, 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 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 lien of such ondlorsement(s).
<br /> PRODUCER NAOMEa.T Amy H.Paschal
<br /> Ken B Lawson,Jr. A&N%EAsi, '919-846°2090 ext 105 AACnNo):: 919-846-2438
<br /> dba Lawson Insurance Group,Inc. EMAIL
<br /> ADDRESSS, paschaa@nationwide.com -
<br /> .........
<br /> 6512-101 Six Forks Road INSUFIErkS AFForROINOCOVERAGE II,�r,ao-c�
<br /> I.1__..._ . . _. I ..
<br /> Raleigh,NC 27618 INSURER Nationwide Mutual Insurance Company
<br /> ............— --- - -
<br /> INSURED ....INSURERB: AmGUARID Insurance Company
<br /> ProNet Systems,Inc.
<br /> y ENSURERC. Nationwide Fire Insurance Company
<br /> 3200 Glen Royal Road INSURERD: Progressive Southeastern Insurance Co.
<br /> �'*� .... ...- — ..
<br /> Suite 1017 _INSPRER E.
<br /> - ............-_....
<br /> Raleigh, NC 27617 INSURER r
<br /> COVERAGES CERTIFICATE NUMBER- REVISION NUMBER:
<br /> THIS 15 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTCI"THSTANDING 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 -- Ab L SUffk .. ...... POLICY NUMBER P hYYdnf'fYY'd. ,,,,,IMPo606Yt'KXY, ,,,,,,,,,,,, — ._._........ ..... .....
<br /> LTR -. TYPE OF INSURANCE LIMITS
<br /> 1 X' CGMMERCIAL GENERAL LIABILITY I ACP'2262994383 ,026221201402/22.!2015 EACHO CURRENLE s 1,000,000
<br /> ... .... CJA- AGE TO klENR l ' _
<br /> A O-AIMS-MADE OCCUR 100 000
<br /> y .I JdF;MISFS F„,occurrence r
<br /> contractual Liability ME E xP I!Any one person) J s 5,000
<br /> _.._.
<br /> X Contractor's Enhancement
<br /> _. PERSONA( ADV1N aRY $ 1,000,000
<br /> EE
<br /> POLICY�X T APPLIES cO FR�E lI II c to DFr z �4 c � 2 000,000
<br /> REGATE s 2,0
<br /> I°cYC �
<br /> GEN I AGGREGATE ATE-L W ..._..
<br /> 00,000
<br /> 07 HER
<br /> C AUTOMOBILE LIABILITY 1 ACP 3006921314 1263162014�12/31/2o1'Se C EN aEl�i SiNI u F LIMIT
<br /> $ 1,000 000
<br /> D —
<br /> ANY AUTO 07864851-3 0A/13/201141213112014'soDlLr MAAR r fflef p,rsrY, t
<br /> �„Al-L.OWNEI.) 'SCHEDULED BODILY INJURY(Peraccldenll $ ....
<br /> HIRED AUTOS + NONIXY'MEl0 4 PROPER Y DAMAGE......... �$
<br /> 1S
<br /> X UMBRELLA LIAR OOcUR ACP 2262994383 0262212014 0212212015 EACH rx,c„IERRENCE $ 4,000,000
<br /> A X ExCESSUAB CLAIM-5-MADE AGGREIATE $ 4,000,000
<br /> _ - . _ .. ....
<br /> DED �X ' RETEN11ON s None s.
<br /> AoDREMPPL EMPLOYERS' �� �YEDUrIVE y PRyJIPC552943 f04/03'/201404/03/'2015 . (1 TU]E f,R
<br /> B , NIA j E L EACH ACCIDENT s 5001000
<br /> IMandabory In NH) J I�E1,III EASE-EA EMPLOYEE $ 500,000
<br /> II yes describe under .. .......... __.
<br /> DESCRIPTION OF oPERAT IONS b0ow i E L.DISEASE-POLICY LIMI E $ 500,000
<br /> A ;Business Services Bond 7900388862 0711111201407/11112016'$60,0010.Bond Limit
<br /> 1 (3rd Party)
<br /> DESCRIPTION OBI°OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,.Additional Remarks Schedupe,may be attached If more apace Is rayulredl
<br /> Orange County is included as additional insured where applicable per Blanket Contractors Enhancement Endorsement CG 72 88,.
<br /> Waiver of Subrogation applies per endorsement.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Orange County
<br /> P.0.Box 8181 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Hillsborough,NC 27278 ACCORDANCE WITH'THE POLICY PROVISIONS.
<br /> AUTHORIZED RF.PRE'ENTA�Wa� "q
<br /> (,,,,t 88-2014 XCORD CORPORATION. All rights reserved.
<br /> ACORD 25(20�14101) The ACORD name and logo are registered marks of ACORD
<br />
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