2018-074-E Solid Waste - East Coast Construction Services electrical work

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DocuSign Envelope ID: A926FA77- 8134- 49AC- B9F9- FECEAEOF509A CERTIFICATE OF LIABILITY INSURANCE FDATE 'MMIDDIYYYY) 21212018 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 Rutherfoord, A Marsh & McLennan Agency LLC Company 5606 Carnegie Blvd, Suite 300 CONTACT NAME: certificates@rutherfoord.com PHONE FAX AIC No Ext : Email or Fax AIC No): 804- 788 -8944 ADDRESS: certificates@rutherfoord.com INSURER(S) AFFORDING COVERAGE NAIC # Charlotte NC 28209 INSURER A: Westfield Insurance Company 24112 $1,000,000 INSURED EASTCCOAS East Coast Construction Services, LLC P.O. Box 5528 INSURER B $500 '000 INSURER C MED EXP (Any one person) INSURER D: High Point NC 27262 INSURER E : $ 1,000,000 GEN'L INSURER F: GENERAL AGGREGATE $ 2,000,000 COVERAGES CERTIFICATE NUMBER: 1956272422 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 ADDL INSD SUBR WVD POLICYNUMBER POLICY EFF MM /DDIYYYY POLICY EXP MM /DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y Y TRA4558124 9/30/2017 9/30/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $500 '000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ PRO- JECT ❑ LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ • AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y Y TRA4558124 9130/2017 9/30/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ • X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE TRA4558124 9/30/2017 9/30/2018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 X RETENTION $ 0 $ _7DED A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A Y WCP4555818 9130/2017 9/30/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Orange County c/o Solid Waste Administration PO Box 17177 Chapel Hill NC 27516 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD