2016-416-E DEAPR - Royalwood Associates, Inc. for gymnasium resurfacing service

Browse Search

DocuSign Envelope ID:21 BC4012-AEOE-497D-AD1 E-8BA82EAB66E5 ROYAL-5 OP ID:TL ACOR® DATE(MMfDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 07!19!2016 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). PRODUCER NAMEACT Tammy Coolidge AX Senn Dun-Raleih 4700 ails of Nouse Rd,St 190 INC.No.Esti:919-719-9861 FAX No): 919-372-3716 Raleigh,NC 27609.2521 E-MAIL SS:toolidge@senndunn,com James P,Lowrey INSURER4S)AFFORDING COVERAGE NAIC N INSURER A:Selective Insurance Co of Amer 12572 INSURED Royalwood Associates, Inc. INSURER B:Builders Mutual Ins.Co. 10844 Attn: Don Eidson-CEO INSURER C: P.O. Box 91145 Raleigh,NC 27675-1145 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. INSR TYPE OF INSURANCE ADDL SUBRI POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER IMMIDDPYYYYI 4MMIDDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR S1931429 0410112016 04101/2017 PREMISES(Ea occurrence) $ 100,000 MED EXP(Anyone person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 3,000,000' POLICY X PE O LOC PRODUCTS-COMP/OP AGO $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO 51931429 04/0112016 04101/2017 BODILY INJURY(Per person) $ AtLOWNED SCHEDULED BODILY INJURY(Per aceldenl) S AUTOS - AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accldenq S X UMBRELLALIAB X OCCUR EACH OCCURRENCE S 5,000,000 A EXCESS LIAB CLAIMS-MADE 51931429 0410112016 04/01/2017 AGGREGATE S 5,000,000 DEG X RETENTIONS 0 S WORKERS COMPENSATION AND EMPLOYERS'LIABILITY X STATUTE OTH- ER H Y B ANYPROPRIETORIPARTNERIEXECUTIVE WCP102439603 04/01/2016 04/01/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICERAMEMBER EXCLUDED? Y NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S. 1,000,000 If yes,descabe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) REF: Orange Co,Parks& Roc,-Orange County Government Is Included as additional insureds with regards to general liability as stated in the policy language with written contract prior to any loss. CERTIFICATE HOLDER CANCELLATION ORAN818 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD