2018-014-E DEAPR - Tommy Lawrence Electrical Contractors replace damaged soccer poles

Browse Search

DocuSign Envelope ID: OB94A554- F378- 4C4A- AE6E- 3EF10ADOCF43 LAWRE -1 OP ID: MG CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 12/28/2017 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(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). CONTACT PRODUCER NAME; Phillip Allen Thompson - Alien, Inc, (" ,exu;336 -599 -2175 _ FAX 336 -589 -6932 T P. 0. Box 100 EMAIL Roxboro, INC 27573 Marcia D. Green INSURER A:, Cincinnati Insurance Company 10677 ........... . _.._..._ . - .._... _. __. INSURED . Tommy Lawrence Electrical INSURER s: Cincinnati Casualy Company 28665 Contractor's Inc. INSURER C: P.O. Box 641 — - -` Roxboro, NC 27573 INSURER D: — INSURER INSURER F : n CbTICi/ ATC Al11AAO CO. RFVISInN KII IMRFRt 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. - - -- ILTR - - - - -- — — TYPE OF INSURANCE Ob I STTe POLICY NUMBER POLICY E MMIDDIYYYY POLICY EXP MMIODIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Hillsborough, NC 27278 EPP 0096783 08/16/2017 08/1612018 EACH OCCURRENCE $ 11000,000 DAMAGE TO RE 7 I) PREMISES Ee occurrence $ 100,000 MED EXP (Any one person) $ $;000 PERSONAL E,AOVINJURY $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 PRO- `:. POLICY n JECT LOC _ OTHER: -- S AUTOMOBILE LIABILITY A COMBINED SINGLE LIMIT S,Ed ao cidenQ. $ 1,000,000 _ _ BODILY INJURY (Per person) $ A X ANY AUTO EBA 0096783 0811612017 08/1612018 JU BODILY INRY (peraccident) $ ALL OWNED SCHEDULED AUTOS NON OWNED X HIRED AUTOS X AUTOS PROPERTY DAMAGE Pet accide t $. $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE S 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE EPP 0096783 08/16/2017 08/16/2018 I _ DEL) RETENTION $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE YIN j_� OFFICER /MEMBER EXCLUDED? t' (Mandatory in NH) ---- J If ESCR es, deIPTIscribON e under OP OPERATIONS below D NIA EWC0368238 -02 01/01/2018 61101I2019 STATUTE. R H _X_ E,L. EACH ACCIDENT S 100,000 E. L, DISEASE • EA EMPLOYEE S 100,000 . DISEASE - POLICY LIMIT $ 500,000 r DESCRIPTION of OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Romarks Schodule, may bit attached if more spaoo is roquirod) EMAIL: Itaft @orangecountyne.gov ORANGCG 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. Parks and Recreation Lori Taft 200 South Cameron Street AUTHORIZED REPRESENTATIVE Ia D Green Hillsborough, NC 27278 V 'IV 00-41,1 iff'NVVRV VVRr'Vr%/A I IV IN. Pill I I U I Ito IGb GI vl1w. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD