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2017-686-E AMS - Gonzalez Painters old courthouse
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2017-686-E AMS - Gonzalez Painters old courthouse
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Last modified
10/3/2018 1:36:12 PM
Creation date
10/2/2018 4:39:53 PM
Metadata
Fields
Template:
Contract
Date
10/4/2017
Contract Starting Date
10/10/2017
Contract Ending Date
11/10/2017
Contract Document Type
Contract
Amount
$12,000.00
Document Relationships
R 2017-686-E AMS - Gonzalez Painters old courthouse
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2017
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DocuSign Envelope ID: D545F945-DEA6-4OD2-AC14-26F2DDB35OF2 <br /> KtL,t J,VGfJ F7trI L�/1I711 1`L:1"a <br /> 24-Aug--201? 19:24 t1ctCerrier Telecom SpanDSF Fax [dent p.3 <br /> '44CCPR" CERTIFICATE OF LIABILITY INSURANCE OATE(MMMDNYYYI <br /> 08/2412017 TLM <br /> THIS CERTIFICATE 13 ISSUED AS A MATTER or INFORMATION ONLY AND CONFFRS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CER'nFIGATE 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 1NSURER(S),AUTHORIZED <br /> I>FPkFGCNFATrVF OR{7RAr71tt FR AWn THIC C'FRTIKIt':ATF Wnl DFR <br /> iNIPORTANT It the Ceriftete holder Fe on ADDITIONAL INSURED,the pniicy(Iarr)muss he onda aed, if SUSRoCATiom is WAIVED,subint-I to <br /> the loans and canditlans of the poIiiW,certain Poliriss may require an endorsement. A statement on this certificate dMa not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> YROPUtLN 60" ^L- ANUUNU I3i✓=L:UKNtH INS AC;f=NCY INC <br /> -STRICKLAND INSURANCE BROKERS INC NAME. <br /> -100 COMME=RCE COURT (sUC w.�rLl; 91 ft-286-9500 !lNC,N�1; 91X286-9541 <br /> GOLDSBORO.NC 27534 <br /> A Rtss_ <br /> INSURER(S)AFFORDING MVE77A4F- <br /> INSURES{ raAlcx <br /> rNsumkH A;ATLANTIC CASUALTY INSURANCE COMPANY <br /> lNSUkLkIL d <br /> �""Z-1LEZ PAI;;TEETC°CL"fTft ACTC^v I„ <br /> 4301 BENNETT MEMORIAL RD 149U MC <br /> S'HAPFI HII I N(,';)7514 INSURER 13: <br /> tNSUx6N�. <br /> lN81IRE R P <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS 19 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED SELOW F!Avn BEEN ISSUED TO THE INSUREO NAMED A60VE FOR THE POLICY RER10D <br /> 1N61CATED. t+`O7WPCN.STAW11INC,ANY REQUIREMENT,TERM M. CONDfIlON OF ANY CONTRACT OR OTHER DCX;UMEVT WITH RESPECT TO WHICH THIS <br /> 04-RI11-I(:AIL MAY 13L 1,':ULU MI MAY PL),IAIN, 1;LIt-HWRANtL AFFOROLL3 BY IIIL FOLICIL8 13L-A'.RIULD IILRLIX IS gLJUJL(II 16 ALL IIIL ILF!MS, <br /> ��LX,CLU$1ONS AND COND1 I IONS OF SUCI l POLICIES.LIMI 18 Sf K)W 4 MAY I IAVL BLI-N RLUUOLU UY YAIU CLAIMS, <br /> L BgTRA lYYGVC INyvRJSNCC AeO6 WR P6L Y EFF Pp��LOlN YYTPY LiMll$ <br /> YOCICr HuMaLlL <br /> X ':0MMERCIALGF]VBRALLL BJTY 1.00103949&-1 03/1712017 C131i71.2018 rnrAlncrzlRRrNrx s 1,Ot10,000 <br /> C!AIAL9 AfAnr a8CtR IAA IiS ICI ill-Nlt en S100,000 <br /> A Mr:L]t]®' R Mta parson ,5 MOOD <br /> F�rp lowu R AfN INJURY 41.000.000 <br /> {+rNi Aryf,RrC'/(rf-I1F.{Fr AFF71CSi PrR: C.P' Ai At',[Y.Y'GATr` §2,0W.00 <br /> JtS:I LVS: I'Ft[A]L1C3S-4"UlAMC71ACUti 31,000,000 <br /> ALITOMOKILE UIaILrrY C.C7AE7] 3"77;AIrat r 1 Ilalrf <br /> PAfYAUIU _ _ Egm $ <br /> BODILY INJURY jr rpbr t) ;+ <br /> AWIfrt,%q nu'lrLx^+LS U M7ILY WuKY Q'araw"em <br /> IIIRMAirro: NON L wmi-R PR{1PI-FSrYDAATArf <br /> AUIW <br /> I'BrZiC � <br /> UMAJIM y <br /> VMU LLLA LtAL, C7.Mut EACH U(x.u} 5 <br /> EXCESS I r6R N AIM.'3 MADl- AdWM-,ATr 5 <br /> Irrn InrTrurms <br /> W6'aRKERS COMPEN 3ATIUR <br /> AND MPLoVERW UABIL6T1' i N KATlffr +rr,1 <br /> ANY PR0MEC1VPAMNERIt?][ (MVE r.l.!•Ai:iFAl%'.3{7rN'f S <br /> Vri•IS UNI:Niee14 CACLUIlkV2 N/A <br /> tManiWory In tlFl) <br /> E.LL'tSkb SE-LALM!'LOYt $ _ <br /> r I -9��'R 'cox'&rRATlrra.I:;kw, <br /> L:.A-UISLAS4I=-IKJ'MYwAII $ <br /> z <br /> DESCRIPTION Or OPERATION$d LPOAVON3 I V'ENICL-It$(ACORD te7,A4;9-al 7iern"Ae aefenlele,r11 MY Ib nitechnd if 11r epaue 1u n4vir�rJ <br /> PER POLICY <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY <br /> PO DDX 8181 $HOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> HiLLs gnA.rSLlO If THE 'Xrl ATION BATE THEREOF, NOTICE 4YiLL BE <br /> DFAIVERPO IN <br /> H M__727& ACCORDANCE WITH THE POLICY PItOVISION3, <br /> AUMORIEEDRCPRE3PNTAjIvr <br /> Q)1988,2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014101) Tha ACORD nama and toga are registerad marks of ACORD <br /> i <br /> I <br />
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