2017-551-E AMS - Seegars Fence Company to install custom fence, Eno River Parking Deck

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DocuSign Envelope ID: FFB1ElC1-0882-4DBC-8266-7C20246FC236 A G Da CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/25/2017 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 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 Susan Denton NAME: John Hackney Agency of Rocky Mount (A/C.No EXtr (252)442-3186 FAX (252)451-9400 (252)451-9400 950 Country Club Road E-MAIL ADDRESS:sdenton@ jharm.com P. O. Box 7807 INSURER(S)AFFORDING COVERAGE NAIC# Rocky Mount NC 27804-0807 INSURERA:Selective Insurance Co. of America 12572 INSURED INSURER B:Accident Fund National Ins. Co. 12304 Seegars Fence Co. Inc. of Durham INSURER C: PO Box 61378 INSURER D: INSURER E: Durham NC 27715 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1772503047 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 EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY),(MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED 100 000 A CLAIMS-MADE X OCCUR PREMISES(Ea occurrence) $ X S2174309 08/01/2017 08/01/2018 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY _ $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY x PRO- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: Employee Benefits $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED S2174309 08/01/2017 08/012018 BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY X HIRED AUTOS X AUTOS (Per a cidentDAMAGE $) Medical payments $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED RETENTIONS S2174341 08/01/2017 08/01/2018 $ WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A B E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? n 08/01/2017 08/01/2018 (Mandatory in NH) WCV6'"147075 E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 A Equipment Floater S2174309 08/01/2017 08/01/2018 Rented/Leased equipment $ 125.000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The certificate holder is included as additional insured insured with respects to general liability as required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE Susan Denton/CCB ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)