2017-649-E AMS - Alley, Williams, Carmen & King, Inc. for construction admin services for shower install at CGCC

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DocuSign Envelope ID:00D5239D-4390-42F1-AA3B-CB88F2EE7089 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/11/2017 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 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 NAME: Candice Tickle I.S.C.A. PHONE 475-9762 FAX 336 472-9160 (A/C,No,Ext): (336) (A/C,No): ( ) 310 Hasty School Rd E-MAIL Y ADDRESS: canY@ d iscofa.com INSURER(S)AFFORDING COVERAGE NAIC# Thomasville NC 27360 INSURERA: ACADIA INS CO 31325 INSURED INSURER B: CONTINENTAL CASUALTY COMPANY(CNA) 20443 Alley,Williams,Carmen&King Inc. INSURER C: 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 ADDL SUBR POLICY EFF POLICY EXP LTR INSD SWVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RETE CLAIMS-MADE X OCCUR PREMISES O(Ea occur ence) $ 500,000 MED EXP(Any one person) $ 10,000 A CPA4365511 01/27/2017 01/27/2018 PERSONAL&ADVINJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) X ANY AUTO BODILY INJURY(Per person) $ A AWNED AUTOS ONLY SCHEDULED AUTOS CPA4365511 01/27/2017 01/27/2018 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY (Per accident) X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE CPA4365511 01/27/2017 01/27/2018 AGGREGATE $ 5,000,000 DED X RETENTION$ 10000 PR/COMP OPS AGG $ 5,000,000 WORKERS COMPENSATION �/ PER OTH- AND EMPLOYERS'LIABILITY /� STATUTE ER A OFFICER/MEMBER EXCLUDED? E.L.EACH ACCIDENT $ 500,000 D?PROPRIETOR/PARTNER/EXECUTIVE YNN N/A WCA4365510 01/27/2017 01/27/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 Professional Liability Per Claim $3,000,000 B AEH133331387 12/10/2016 12/10/2017 Aggregate $3,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Project: Cedar Grove Community Center CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Orange County Post Office Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough, NC 27278 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD