2015-659-E DEAPR - Tommy Lawrence Electrical cost saving measures

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DocuSign Envelope ID:66B6B6FA-D80A-427A-A2E0-3B6110A8A171 LAWRE-1 OP ID: MG A,CV CERTIFICATE OF LIABILITY INSURANCE OATE(MMIDDTYYYY) ka......---- 12/0312015 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(les) 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). _ CONT PRODUCER NAMEACT Phillip Allen Thompson-Allen,Inc. PHONE 336.599 2175 FAx 336-599.6932 P.O.Cox 100 IA1C,No,Ext): pvc,No): Roxboro,NC 27573 ADDRESS: Marcia D.Green INSURERS)AFFORDING COVERAGE NAIC II INSURER A:Cincinnati Insurance Company 10677 INSURED Tommy Lawrence Electrical INs°RERB:Cincinnati Casualty Company 28665 P.O.Box 641 Roxboro,NC 27573 INSURER C: INSURER 0: 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. fLTR TYPE OF INSURANCE •OD 1 BR POLICY NUMBER (MMIDDY I IMMJDDmYY) LIMITS LTR INSD WVP A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 500,000 X EPP 0096783 08/1612015 0811612016 DAMAGE 1a RENTFD $ 100,000 CLAI6i5-MADE OCCUR PREMISES(Eaoccurtence) MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 500,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 POLICY PRO JECT LOG PRODUCTS-COMP/OPAGG $ 1,000,000 OTHER: $ AUTOMOBILE LIABILITY (Ea COMBINED SINGLE LIMIT .-$ 1,000,000 (Ea accideni) A X ANY AUTO EBA 0096783 08/16/2015 08116/2016 BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS ON-O JED PROPERTY DAMAGE $ HIRED AUTOS AUTOS JPeraceidenl) 5 X UMBRELLA LIAB X OCCUR w. EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE EPP 0096783 08116(2015 08116/2016 AGGREGATE $ 5,000,000 DED I RETENTION$ 5 WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETOR/PARTNER/EXECUTIVE Y!N WC8966267-18 01/0112015 01/0112016 E.L.EACH ACCIDENT 5 100,000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE, $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORO 101,Additional Remarks Schedule,may bo attached II more space Is required) CERTIFICATE HOLDER CANCELLATION ORANGCG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Parks and Recreation Lori Taft AUTHORIZED REPRESENTATIVE 200 South Cameron Street Marcia D.Green Hillsborough, NC 27278 1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD