2018-279-E DSS - Nice and Green floor cleaning

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DocuSign Envelope ID: 699B3D1 6-OE45-49CE-A743-3OA41 OD5FOC4 DATE (MMIDDIYYYY) ACC) al CERTIFICATE OF LIABILITY INSURANCE 0611112018 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 AMEN D, 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 pollcy, 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 Lester Ins. Group, Inc. TIA The Harper Agency 1037 S. Main St. Burlington NC 27215 CONTACT Martha Dickerson NAME: aHCONNQ Ezt : (336) 227 -4271 No : (336) 222 -9467 E -MAIL martha .dickerson @harpednsurance.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL 0 INSURERA: Penn National Insurance Company POLICY EXP MMIODIYYYY INSURED Nice and Green Commercial Floor Care Services, LLC 2108 Quakenhush Road Snow Camp NC 27349 INSURERS i X INSURER C: INSURER D: INSURER E: INSURER F: S 1,QOQ,000 COVERAGES CERTIFICATE NUMBER; GL1841909048 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 AUDLISVISH INSR D. POLICY NUMBER POLICY EFF MmmofyYYy POLICY EXP MMIODIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,QOQ,000 CLAIMS -MADE Fx_] OCCUR PREMISES Ea occurrence S 1,000,000 MED EXP (Any one person) S 5,000 PERSONAL aADVINJURY $ 1,000,000 A GL90733918 01131/2018 01/31/2019 r GENERALAGGREGATE $ 2'000,000 �GFN'LAGGREGATELIMITAPPLIESPER: !O POLICY 0 jg Q ❑ LOC PRODUCTS - COMPlOP AGG $ 2'000'000 Automatic Additionallnsd $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accidenC $ BODILY INJURY (Per person) $ ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident! $ PROPER DAMAGE (Per a=id TY I ) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 4EXCESS AGGREGATE $ LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN H STATUTE ER ANY PROPRIFTORlPARTNERIEXECUTIVE ❑ OFFICE R1M.Eh-0BER EXCLUDED? NIA E.L. EACH ACCIDENT $ IMandalory In NHl E.L. DISEASE - EA EMPLOYEE $ II yes, describe udder DESCRIPTION OF OPERATIONS below F.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS! LOCATIONS I VEHICLES (ACORD 101, Addlilonal Remarks Schedule, may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Dept of Social Services ACCORDANCE WITH THE POLICY PROVISIONS. 1130 Mayo Street AUTHORIZED REPRESENTATIVE Hillsborough NC 272787- r, C 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD