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DocuSign Envelope ID:A45C1 1 C6-3162-44FB-82E4-F3B430644D4E
<br /> l TER-1 OP I,D: L
<br /> DATE(MMIODNYM
<br /> CERTIFICATE OF LIABILITY INSURANCE 0811 412015
<br /> THIS CERTIFICATE IS ISSUED AS A a MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS HTS UPO THE CERTIFICATE MOLDER. THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFF'ORDE'D BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER„AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate Molder is an ADDITIONAL INSPIRED, the policy(l s) 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 GndrxrserDaerlt )e
<br /> PRODUCER NTACT
<br /> NAME: Sonya Noble
<br /> 3625 lm St.OSO PHONE o.Earl:336-346-1305 �_ ItgL_336 61 m3S1
<br /> Greensboro,NC 27465 E-MAIL
<br /> Fuss B.Bell,,CIC ADDRESS.,snoble@ enndL nin co
<br /> fNSURERI 1 AED°C7RDING COVERAGE 91AIC#.._.w.
<br /> INSURER A;Cincinnati Insurance Co. 10677
<br /> INSURED Muter Construction,LLC INSURER B:Hanover'Insurance Croup
<br /> John Muter :
<br /> 100 N.Arendell Ave INSURER c
<br /> ebulon, NC 27597 INSURER D
<br /> INSURER.E:
<br /> 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 NAKED 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 /> ........_..._..._.._
<br /> a&DbL R1i3.. ---WCILICW°'€F!F 1 POLII"a's'EAF^ L @1�16TS
<br /> LTR TYPE,OF INSURANCE POLICY NUMBER i MI�AiDDNYYYM MMIDDIYYY
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> A COMMERCIAL GENERAL LIABILITY ENP 0222614 0110812015 0110812016 q r RENTED
<br /> EIS 100,000
<br /> .__......._.._ ( w'�REMISES�d,E_a Ozcc¢amence� $
<br /> l CLAIMS-MADE f ]OCCUR fiIEDEXP(Any one person) S 10,000
<br /> _... -
<br /> r —_ $_— .. 0.
<br /> PERSONAL S ADV INJURY $ 1,000,000
<br /> GENERAL 2'000 00
<br /> GEN'PAGGRE TELIMITtAPPLIE�S E 'S
<br /> : PRODUCT -COMP1OSPAGG ..$_.,,.._ ..._,;2,00"0,000'
<br /> PO-AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> �_ 1,,000,00
<br /> ___..,, Sa accan4.2. . ......... .....
<br /> A X j ANY AUTO ENP 0222614 0110812015 0140812016 BO01LM INJURY IPer person) �
<br /> . ...myAI.LOVA+I'+IFD 'SCHEDULED s 03G'DILMIhIJURY(Per accident)
<br /> $
<br /> AU"IOS AUTOS
<br /> HIRED AUTOS NON OWNED PRC7PER'f v iC7A-DA -.._ .. . .....,.
<br /> _,......... AUTOS ._j'PDR ACCN_6IJT).....,_..._. S
<br /> UMBRELLA LIAS OCCUR EACH OCCURRENCE $ 5,000,000
<br /> A EXCESS LIAR ?d.qLh.MS-MADE X ENP 0222614 0110812015 0110812016 AGGREGATE $ 5,000,000
<br /> IJED RETENTION$
<br /> WORKERS,COMPENSATION mm.. WC STATU- Oli
<br /> AND EMPi OYERT LIABILITY 1ORY_uAfiIT3 _ _ _
<br /> A ANY PROPRIETOR/PARTNERlE'ECUTIVE Yr E CO292810-00 0110812015 01101112016 E L EACH ACCIDENT $ 500,000
<br /> OFFlC-RIMEMBER EXCLUDED? N V A
<br /> (M�andaacerrgr in NH) E L.LronsEASF-EA EMPLOYEE $ 500,000
<br /> If yyes describe under —._�. ...._....
<br /> -......- .-......
<br /> DESCRIPTION OF OPERATIONS below F.C..DISEASE POLICY LIMIT $ 500,000
<br /> B Leasod/Rented IH -A095942-02 0910312015 0960312015 Limit 315,375
<br /> Equipment D d 2,50
<br /> i
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,it rraore space.Is requIred)
<br /> Magistrate Structural
<br /> Orange County is additional insured with respects to General Liability
<br /> arising from the operations of the Named Insured as required with written.
<br /> contract.30 days prior written notice off' cancellation except 10 day
<br /> nonpayment of premium is required to the certificate holder.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> C N18
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION. DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Att- Tammy C mar
<br /> R C Box 6181 AUTHORIZED REPRESENTATrvE
<br /> Hillsborough,NC 27278 Ott,
<br /> ID 1088-2010 ACORD CORPORATION. All rights reserved.
<br /> ACCIRD 25(2010105) The ACORD name and logo are registered marks of ACORD
<br />
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