2018-174-E AMS - National Power WCOB generator

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DocuSign Envelope ID: 674796AD -70F3- 4709- B017- 1E5E84D83DBC OP ID: AH 14AL7°' LY CERTIFICATE OF LIABILITY INSURANCE 7,T"212712017 E(MMIDDIY 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 he 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 SNIPES INSURANCE SERVICE, INC NAME: Amy_ G. Hartle PO BOX 1165 IMC..No, e,,1:910-892-2121 FAX . No): 910 -892 -5228 DtJNN, NC 28336 _A DBEs: alny @snipesins.com DAL SNIPES PRODUCER rusrnMFR In re NATIO -3 INSURED NATIONAL POWER CORPORATION 4541 PRESLYN DRIVE RALEIGH, NC 27616 CINCINNATI INSURANCE COMPANY 410677 CINCINNATI CASUALTY 128665 COVERAGES CERTIFICATE NUMBER- REVISION NLJMRFR: 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 I TYPE OF INSURANCE AD R SUER POLICY NUMBER MMIDDIYY F hMIDO;YYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. • X COMMERCIAL GENERAL LIABILITY X EPP 039 26 42 07101/2017 07101!2018 PREMISES Ea occurrence $ 100,00 CLAIMS -MADE � OCCUR MED EXP (Anyone person) $ 5,00 PERSONAL&ADV INJURY S 1,000,00 X PER PROJ AGGRE X XCU INCLUDED GENERAL AGGREGATE $ 2,000:00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY PRO- X LOC $ • AUTOMOBILE LIABILITY ANY AUTO x EBA 039 26 42 0710112017 071011201$ COMBINED SINGLE LIMIT (Ea accident} BODILY INJURY (Per person) $ 1,000,000 $ X. ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (PER ACCIDENT) $ X X $ NON -OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 A EXCESS LIAB CLAIMS -MADE EPP 039 26 42 07101/2017 07101/2018 DEDUCTIBLE *FOLLOW F $ X $ RETENTION S 0 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE WC STRTU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? ® NIA (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ "yes, describe under "j-SCRIPTION OF OPERATIONS below S E.L. DISEASE • POLICY LIMIT A ERROR & OMISSIONS EPP 039 26 42 07/01/2017 0710112018 OCCIAGGR 1 mm/1 mm A jCargolTransit EPP 039 26 42 07/0112017 0710112018 Any One 130,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES Attach ACORD 101, Additional Remarks Schedule, iF mare s ce is required ORANGE COUNTY IS AN ADDITIONAL INSURED FOR BOTH GENERAL LIABILITY AND AU O LIABILITY AS REQUIRED BY WRITTEN CONTRACT PER CARRIER FORMS GA233 0207 AND AA4171 1105 CFRTIFICATF HOI RFR C:AN('FI I ATION ORANG -1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ORANGE COUNTY ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 8118 HILLSBOROUGH, NC 27278 AUTHORIZED REPRESENTATIVE 0 1985 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD