2017-468-E ES - Phoenix Fire Protection, Inc. to design and install wet sprinkler systems

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DocuSign Envelope ID:423C8EF7-6EE7-45F3-905B-450983CBDD86 PHOEFIR-01 MAIRINGTON A'`Ci � CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDlYYYY) �--� 0813012017 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(ies)must have ADDITIONAL INSURED provisions or 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 CONTACT Melanie A.Airington NAME: TriSure Corporation-HS 4325 Lake Boone Trail,Suite 200 (PJC,NN ,Ext):(919)469-2473 FAX No):(919)467-4987 Raleigh, NC 27607 AI oARESS:mairingtonctrisure.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:EVerest Indemnity Ins. Co. 10851 INSURED INSURER B:Employers Mutual Casualty 21415 Phoenix Fire Protection,Inc. INSURER C:Accid ent Fund Insurance Co 10166 John Schrull 2863 Lee Ave INSURER : Sanford, NC 27330 INSURER : 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD (MM!DDIYYYY) (MM!DDIYYYY) A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 51GL006747171 04/22/2017 04/22/2018 DAMAGE TO RENTED 50 000 PREMISES(Ea occurrence) $ X E&O I m i112m it MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X JPCT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER $ B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) $ X ANY AUTO 4E7210918 04/22/2017 04/22/2018 BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ X AUTOS ONLY X AUTOS0 N (Per accident) X Comp$500 A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 EXCESS LIAB CLAIMS-MADE 51 CC002395171 04/22/2017 04/22/2018 AGGREGATE $ 5,000,000 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y N WCV6143187 04/22/2017 04/22/2018 EL EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N f A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ B Leased/Rented 4C7210918 04/22/2017 04/22/2018 Limit 150,000 B Installation 4C7210918 04/22/2017 04/22/2018 Limit 167,000 DESCRIPTION OF OPERATIONS!LOCATIONS!VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g y ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE jiLteGVZ(10 (4211.4—) ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD