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13 <br />A�QRL]0 DATE (MMIDDIYYYY) <br />� CERTIFICATE OF LIABILITY INSURANCE 10/29/2013 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />Christensen Group Insurance <br />11100 Hren Road West <br />Minnetonka MN 55343 <br />CONTACT Kell Preston <br />NAME: y <br />PHONE (952) 653-1000 FA No: (952)553 -11.01 <br />ED➢AIE .kpreston @christensengroup.com <br />INSURERS AFFORDING COVERAGE <br />NAIC 9 <br />WSURERA:Zurich American Ins. Co. <br />POLICY EXP <br />(MMIDDIYYYYI <br />INSURED <br />CERES ENVIRONMENTAL SERVICES, INC. <br />3825 85th Ave North <br />Minneapolis MN 55443 <br />INSURER 13 'Markel Int r 1 Ins. Co. Ltd <br />GENERAL LIABILITY <br />INSURFRC:Star Indemnity and Liability <br />Tyler Simmons /KP <br />INSURER D: <br />INSURER E: <br />EACH OCCURRENCE <br />INSURER F: <br />COVERAGES CERTIFICATE NUMBER:13 -14 - MASTER - REVISION NUMBER: <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR I <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />POLICY NUMBER <br />POLICY EPP <br />JMM1DDrTYYY1 <br />POLICY EXP <br />(MMIDDIYYYYI <br />LIMITS <br />Hillsborough, NC 27278 <br />GENERAL LIABILITY <br />Tyler Simmons /KP <br />EACH OCCURRENCE <br />$ 1,000,000 <br />X COMMERCIAL. GENFRAL LIABILITY <br />DAMAGE <br />REMISES Ea occurrence) <br />$ 300,000 <br />A <br />CLAIMS -MADE F—x] CCCUR <br />X <br />X <br />L05911870 -01 <br />8/18/2013 <br />8/18/2014 <br />MEDEXP (Any one person) <br />$ 10,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS- COMPIOPAGG <br />$ 2,000,000 <br />POLICY X PRO LOC <br />$ <br />AUTOMOBILE <br />LIABILITY <br />CO acc dED SINGLE LIMIT <br />2,000,000 <br />$ <br />BODILY INJURY (Per person) <br />$ <br />A <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />X <br />X <br />AP9313049 -02 <br />8/18/2013 <br />8/18/2014 <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />NON -OWNED <br />HIRED AUTOS AUTOS <br />INCLUDES COVERAGE FOR <br />$ <br />ORIDA <br />C <br />X <br />UMBRELLA LIAR <br />OCCUR <br />EACH OCCURRENCE <br />$ 1,000,000 <br />AGGREGATE <br />$ 1,000,000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />1000020303 <br />8/18/2013 <br />8/18/2414 <br />DE❑ I I RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y J N <br />ANY PROPRIETOWPARTNERIEXECUTIVE❑ <br />X I WG SLATU- OE H- <br />E.L. EACH ACCIDENT <br />$ 1. 000 000 <br />Mandatory InNH)EXCLUDED? <br />NIA <br />C9313050-02 <br />8/18/2013 <br />8/18/2014 <br />E.L. DISEASE -EA EMPLOYE <br />$ 1,000,000 <br />"yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />}{ <br />INCLUDES MARYLAND <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />13 <br />Contractors Pollution <br />X <br />X <br />13CPLOMW40040 <br />8/18/2013 <br />8/18/2014 <br />Each Condilton &Claim: $5,000,000 <br />Claims Made Policy <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES {Attach ACORD 101, Additional Remarks Schedule, if more space Is required) <br />Certificate Holder is included as an Additional Insured under all policies excluding Workers Compensation <br />when required by written contract. <br />CERTIFICATE HOLDER CANCELLATION <br />ACORD 25 (2010105) <br />INS026 (201005).01 <br />O 1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />Orange County North Carolina <br />RFP# 5193 <br />AUTHORIZED REPRESENTATIVE <br />200 S Cameron Street <br />Hillsborough, NC 27278 <br />Tyler Simmons /KP <br />ACORD 25 (2010105) <br />INS026 (201005).01 <br />O 1988 -2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />