2018-631-E AMS - National Power WCOB generator

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DocuSignn Envelope ID:7DEOB21B-2311-42D3-BC59-5E3FO4D4843D OP ID:AH 1 CERTIFICATE OF LIABILITY INSURANCE D.121271201 YY' 12127!2417 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. Hartley FAX PO BOX 1165 O Af No •910-8'92^2121 JAIC,No):910-892.5228 DLINN, NC 28335 ADDRESS:am Snl €`s111S.Corn DAL SNIPES PRODUCER cusTomEg 1p#NATIO-3 1NSU RER(S)AFFORDI NO COVERAGE NAIC# INSURED NATIONAL POWER CORPORATION INSURERA:CINCINNATI INSURANCE COMPANY 10677 4541 PRESLYN DRIVE INSURER Ia;CINCINNATI CASUALTY 28665 RALEIGH, NC 27616 INSURER C: INSURER D: INSURER E: INSURER F 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 I ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR -WVn POLICY NUMBER MMIDDIYY YY) IMM1001YYYY1 LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000. • X COMMERCIAL GENERAL LIABILITY X EPP 039 26 42 07101/2017 0710112018 PREMISES Ea occurrence $ 100,00 CLAIMS-MADE F_x1 OCCUR MED EXP(Anyone person) $ 5,00 X PER PROJ AGGRE PERSONAL&ADV INJURY $ 1,000,00 X XCU INCLUDED GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMITAPPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO FX1 LOC $ AUTOMOBILE LIABILITY X, COMBINED SINGLE LIMIT $ 1,000,000 EBA 039 26 42 0710112017 07101/2018 (Ea accident} • X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS ^PROPERTY DAMAGE X HIRED AUTOS (PER ACCIDENT) $ X NON-OWNED AUTOS $ $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 55,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000 A - EPP 039 26 42 0710112017 0710112018 DEDUCTIBLE 'FOLLOW F $ X RETENTION S 0 $ WORKERS COMPENSATION WCSTRTU- OTH- AND EMPLOYERS°LIABILITY YIN TORY LlMrrs I ER ANY PROPRIErORIPARTNERIEXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatary in NH) E.L.DISEASE-EA EMPLOYE $ .`yes,describe under "j`SCRIPTION OF OPERATIONS below 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 0710112017107101/2018 Any One 130,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES Attach ACORD 101,Additional Remarks Schedule,it more 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 CERTIFICATE HOLDER CANCELLATION ORANG-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ORANGE COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX.8118 HILLSBOROUGH, NC 27278 AUTHORIZED REPRESENTATIVE 0 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD