2018-107-E AMS - LRC air quality testing 129 E King

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DocuSign Envelope ID: 4D27BC63- FB29- 49D9- BADC- A294038D9962 AC"R" CERTIFICATE OF LIABILITY INSURANCE 1 . DATE(MM /DD/YYYY) 02/09/2018 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 endorsements . PRODUCER Nobles Insurance Agency 224 HIGH HOUSE RD, SUITE 102 CARY NC 27513 CONTACT GARY NOBLES PHONE (919) 467 -1703 FAX (919) 467 -3103 EMAIL NOBLESG @NATIONWIDE.COM INSURERS AFFORDING COVERAGE NAIC # INSURERA:NATIONWIDE INSURANCE 23779 06/24/2017 INSURED LRC INDOOR TESTING &RESEARCH INC INSURERB:CINCINNATI INSURANCE COMPANY 10677 CLAIMS -MADE � OCCUR 140 IOWA LN INSURER C SUITE 102 INSURER D $ 100,000 INSURER E MED EXP (Any one person) CARY NC 27511 -4498 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 ADDL win SUER wyn POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY ACP GLG02293464239 06/24/2017 06/24/2018 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR DAMAGES ( RENTED Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 GEN'L X POLICY JE� 1:1 LOC PRODUCTS - COMP /OP AGG $ 2,000,000 1 $ OTHER I 1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE (Per accident) $ NON -OWNED HIRED AUTOS AUTOS A UMBRELLA LIAB X OCCUR ACP CAF 2293464239 06/24/2017 06/24/2018 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 X EXCESS LIAB CLAIMS -MADE DED RETENTION $ B WORKERS COMPENSATION 6C28UB- 2E28464 -1 -17 06/24/2017 06/24/2018 PER X OTH- STATUTE ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE Y� E.L. EACH ACCIDENT $ 1'000'000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) A NIA E.L. DISEASE - EA EMPLOYEE $ 1'000 000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) When required by written contract the certificate holder is included as additional insured with regards to General Liability. Endorsement CG 2010 CERTIFICATE HOLDER CANCELLATION A1007598 Fax: ( ) - @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ORANGE COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ABARNES @ORANGECOUNTYNC.GOV ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 8181 AUTHORIZED REPRESENTATIVE HILLSBOROUGH NC 27278- Fax: ( ) - @ 1988 -2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD