2018-216-E AMS - AD Area vacuum Eno River Parking Deck

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DocuSign Envelope ID: OF99OC3F- 5655 -44AD- BAFB- 8904E9644683 CERTIFICATE OF LIABILITY INSURANCE 17/5/18 DATE (MMroorcryr) 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 1S 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 NAME T Brandy Martin AAI- Nationwide Insurance jkorN . 919- 732 -2692 DEC No).* 919 - 732.6328 PD Box 939 E -MAIL : martib5O@nationwide.com Hillsborough NC 27278 INSURE S AFFORDING COVERAGE _LAIC# INSURER A: Nationwide Insurance 21 378 INSURED INSURER 6: Travelers Insurance _2_1487 A D'S Area Vacuum Service Inc, INSURER C: 3734 Mallory Ct. INSURER D: _ Hillsborough, NC 27278 . 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 SUBR POLICY NUMBER POLICY EFF MNIfDDIYYYY POLICY EXP MMIDDIWYY LIMns A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS-MADE 11 OCCUR Hillsborough, INC 27278 tcomar@orangecountync.gov ACP GLGO 2206314196 0$122117 D8122/18 P EACH OCCURRENCE $1.000,000 DAMAGE N D PREMISE Es ocourreLkce $100,000 MEDEXP (Any one person) $6.000 PERSONAL & ADV I NJ URY $1000000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY J'E'c'T F7 Los PRODUCTS - ComPIOP AGG s2,000,000 5 A AUTOMOBILE LIABILITY ANY AUTO ALL AUTOS T AUTO5uLE0 NON -OWNED HIRED AUTOS AUTOS ,ACP BA 2206310196 08122117 I L 08122/18 Ea afBIINEED SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE r accident $ i $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECU -nVE OFFFCERiMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under ❑ESORIPTION OF OPERATIONS below NIA 6JUB- SH34169 -8 -17 9/22117 9t22f18 WC STATU- 1 10711- . E.L. EACH ACCIDENT $100,0()o E.L. DISEASE - EA EMPLOYEE $100,000 E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required.) CERTIFICATE HOLDER CANCELLATION ACORD 25 (2010105) - O 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 8181 AUTHORIZED REPRESENTATIVE Hillsborough, INC 27278 tcomar@orangecountync.gov ACORD 25 (2010105) - O 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD