|
85
<br /> County of Orange, NC RFP#5183
<br /> INSURANCE CERTIFICATES
<br /> ----Ie
<br /> /CORD CERTIFICATE OF LIABILITY INSURANCEpage 1 of 2 �TEIMA° )
<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 INSURERIS),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the cettlfloate holder Is an ADDITIONAL INSURED,the colicy(ies)mustbe endorsed. If SUBROGATION IS WAIVED,subject
<br /> to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights
<br /> In the certificate holder In lieu of such endorsement(s),
<br /> PR:DUOER CONTACT
<br /> Mills of Neeaaahueotta, Ina. NANO:
<br /> o/0 16 Century Blvd. ,A_ ,LXt,PxoTB77-945-7378 1 j� mny 088-467-2378
<br /> P. o. Box 305191 arvwEL.ac oertifioateeRwillie.nom
<br /> Nashville, TH 37130-6191 INEURER(epAEFORBUq COVERAGE NAOS
<br /> maim Dorian A,eaca nen In novenae Company 16535-002
<br /> INSURED INSURER R;AmerLaan Guarantee and Liabili Cy Inautenc 26247-003
<br /> clean Harbors Env iroman tel Beryieee, Ina.
<br /> and ite affiliatee INSURER G.50aadfast Inauranae Company 26307-001
<br /> 43 Lon5Uater Drive ..
<br /> Norwell, NA 02001 INSURER 13:
<br /> INSURER
<br /> I INSURER F.
<br /> COVERAGES REVISION NUMBER:
<br /> This IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED 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 oY PAID CLAIMS.
<br /> waR ADa.sue• (MMTIONYYVY) teui ESP)_ Lam
<br /> ITR TYPE OFINSUAANLE I ,,, POLICY NVNBER
<br /> A •DENEBALLweILrry Y GLO 9601229-05 11/1/2013. 11/1/2012 pEAAccH[agccusesNcF s 2.000.000
<br /> X OOMMENOtSL GENERAL LIASLITY FRE IIA RE' nilt A m $ 100,000
<br /> ■■CLAIMe-MADEE1 OCCUR MED EXP(Any one person) 9 5,000
<br /> II XCO .__,,,_, PERSONAL a ADVVAJURY 5 2,000,000
<br /> N Cenrraatual GENERALACONEOATE $EN 3,000,000
<br /> ( GL AGGREGATE ATELIMIT AERIES PER: PRODUCTS.COAIPAJPADO 1 2,000.000
<br /> 11.0.10Y l 7L A 1. n LOO $
<br /> A AUTOMOBILE LIABILITY y HAP 6601231-05 11/1/2011 11/1/2012 W e wO
<br /> SLEULIIT $ 5,000,000
<br /> © ANY AUTO 1BDDILY INAWY(Per Posoa) 5
<br /> IIIALL OWNED BCHEEULED
<br /> AUTOS AUTOS BODILY INJURY(PorecdduN) S
<br /> © 1-0REDAUrOS VO.SANEO arFJY OAMAOE $
<br /> H ® Nos-90 1 5
<br /> UMBRELLALIAB X OCCUR AIIC4275262-07 11/1/2011 11/1/2012 FACel OCCLRRENCE $ 10,000,000
<br /> ■ excess Las CLAIMS-MADE AGGREGATE $ 10,000,000
<br /> GED RETENTIONS 7
<br /> A WORKERS COMPENSATION WC 9601232-05 11/1/2011 11/1/2012 IC ITTiavf AMrnsi I°EP
<br /> AM EMPLOYERS'LIABILITY y(
<br /> ANY PROM BTOWPARTN FLEXECUTIAT N NSA EL.EACH ACCIDENT $ 2,000,000
<br /> OF FICER9MEMBERIXIX.UDFDT !'•1 •-
<br /> IRN1indalea NH) EL.DISEASE.EA EMPLOYEE$ 2,000,000
<br /> Iryya do uTder
<br /> bESCRIPIIONOF OPERATIONS nelp'!I EL DISEASE•POLICY LIMN 5 2,000,000
<br /> C POC 3656681-26 CPA 11/1/2011 11/1/2012
<br /> ConCrecEcra Pollution 010,000,000 Each Claim
<br /> Liability 510,000,000 ALE Claims
<br /> DESCRIPTION OP OPERATIONSI LOCATIONS!VEHICLES(Attach cad isi wallonaI Remoras 5s Wale,M more ip ice lc squired)
<br /> See Attached:
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> -- For Referenda Only -- AUTHORIZED REPRESENTATIVE
<br /> 01980-2010 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
<br /> Company Confidential 37 www.cleanharbors,com
<br /> i
<br />
|