2018-023-E DEAPR - Tommy Lawrence Electrical convert lighting to LED

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DocuSign Envelope ID: C46D23E4- B577 -47BD- 9855- BB6340726948 LAWRE -1 OP ID: MG �.- CERTIFICATE OF LIABILITY INSURANCE r ATE(MMIDD /YYYY) 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($), 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). PRODUCER Thompson - Allen, Inc. P. O. Box 100 Roxboro, NC 27573 Marcia D. Green n cNAMNT Phillip Allen ___ FAX PHONE 336 -599- tn/a Nom ExI _ (n/a N°): 336- 599 -6932 ^_ E MAIL ss: - INSURERS) AFFORDING COVERAGE NAIC P _ INSURER A: Cincinnati Insurance Company 10677 EACH OCCURRENCE INSURED Tommy Lawrence Electrical INSURER B: Cincinnati Casualty Comparjy _ 28665 _ Contractor's Inc. P.O. Box 641 INSURER 0: PERSONAL & ADV INJURY $ 600,000 Roxboro, NC 27573 INSURER D: $ 2,000,000 PRODUCTS - COMP /OPAGG $ 1,000,000 INSURER E: $ INSURER F: AUTOMOBILE LIABILITY JX ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOOWNED HIRED AUTOS X AUTOS 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 LTR TYPE OF INSURANCE Adb 4 � POLICY NUMBER M� ICY FF MM ICY LIMITS A X GEN'L COMMERCIAL GENERAL LIABILITY CLAIMS -MADE T OCCUR Hillsborough, N C 27278 M EPP 0096783 0811612017 08/1612018 EACH OCCURRENCE $ 11000,000 DAMA SET Bfta occurrence) $ 100,000 MED EXP (Any one person) _ $ 5,000 PERSONAL & ADV INJURY $ 600,000 AGGREGATE LIMIT APPLIES PER: POLICY I " 1 PRO D LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OPAGG $ 1,000,000 $ A AUTOMOBILE LIABILITY JX ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOOWNED HIRED AUTOS X AUTOS EBA 0096783 08/1612017 08116/2018 COMBINED SINGLE LIMIT _ a accident) _ $ 1,000000 _ ___ r 60DILY INJURY (Per person) s BODILY INJURY (Per accident) $ PR P TY DAMAGE APer accidentl___ $ ..._ A �( UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE EPP tl096783 08116/2017 08!1612018 EACH OCCURRENCE $ 5'5,000,000 I AGGREGATE s 5,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROP RIETORIPARTNERIEXECUTIVE YIN OFFICER /MEIABER EXCLUDED? P41 (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below N I A EWC 0368238 -02 01/01/2018 01/01/2019 PER 0 H- X STATUTE ER .._ E.L._ EACH ACCIDENT ___....___._.._.. $ 100,000 E.L. DISEASE • EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Romarks Schodulo, may be alt ehod if more spaoc Is roquirod) EMAIL: Itaft @orangecountyne.gov CERTIFICATE HOLDER CANCELLATION ORANGCG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Government g Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, Parks and Recreation Lori Taft AUTHORIZED REPRESENTATIVE 200 South Cameron Street la D Green Hillsborough, N C 27278 M ©1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD