2017-710-E AMS - Warren Hay jail circuit repair

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DocuSign Envelope ID: B609CD31-DACE-456A-91E0-9865ED037F19 .a+�v►�o` CERTIFICATE OF LIABILITY INSURANCE DATE(M MID DNYYY) 11/1/2017 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 pollcy(ies)must be 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 Crystal Ireland NAME! Y Business Insurers of Carolinas PHONE �x�: (919)968-4611 FAX(AI Na);{919)458-0991 800 Eantowne Drive, Suite 208 EMAIL c3reland@business ineurers.aom ADDRESS: _ _ PO Box 2536 INSUR 5 AFFORDING_COVERAGE NAIC4 Chapel Hill HC 27515-2536 INSURERA:Penn National Ins. Companies 14990 INSURED INSURER 9 Bridgefield Casualty Insurance 10335 Warren-Hay Mechanical Contractors Inc INSURER C! Sheet Metal Duct Suppliers. LLC INSURERD: PO Box 818 INSURER E Hillsborough NC 27278 INSURERF: — COVERAGES CERTIFICATE NUMBERCL16121917124 REVISION NUMBER: I 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 VATH 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. IHSR ADDL�§99A, _ PIILICY EFF POLICY EXP LTTd TYPE OF INSURANCE I ppLICY NUMBER MMfDD1YYYY MMIDDFYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MAID X OCCUR PREMISES(Ea occurrence) S 100,000 CX90726312 12/31/2016 12/31/2027 MEDE%P(Anyoneperwn) $ 10,000 PERSONAL&ADV INJURY $ - 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X IPOLICY 1 PRO- J£CT I LOG PRODUCTS-CpMP10PAGG 3 2,000,000 i OTHER: S AUTOMOBILE LIABILITY ! COMBINED SINGLE LIMIT g 1,000,000 (Es acddeall X ANY AUTO BODILY INJURY{Per person] j S A ALI.OWNED � ,SCHEDULED 1 AX90726312 12/31/2.016 12/31/2017 BODILY INJURY(Per accldenl) S AUTOS I AUTOS NONHIRED AUTOS - AUTOS OV4NED e acad nl)AMAGE PROPERTY S Endorsements I S X UMBRELLA LIAB X OCCUR EACHOCCURRENC£ $ 3,000,000 A E%CESS LIRB CLAIMS-MADE AGGREGATE _ $ 3,000,000 DED RETENTIONS ULD0726312 12/31/2016 12/31/2017 $. WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN X STATUTE ER_ ANY PROPRIETOFIIPARTNERIFYECUTIVE � E.LEACHACCIDENT 15 500,000 OFFICEWMEMBER EXCLUDED? I N I N I A B (Mandatory in NH) 0196-40173 12/31/2016 12/31/2017 E.L.DISEASE-EAEMPLOYEld3 500,000 If yes,describe under --- DESCRIPTION OF OPERATIONS below _ E.L.DISEASE-POLICY LIMIT S 500,000 A 1 Leased/Ranted Equipment �CX90726312 12/31/2016 12/31/2017 LIMIT $50,00❑ DEDUCTIBLE $5 00 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Addlllonal Remarks Schedule,may be attached if more spaco Is required) i CERTIFICATE HOLDER CANCELLATION abarneB@)orangecountyllc.gov SHOULD ANY OF THE ABOVE;DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillaborougtar NC 2727B AUTHORIZED REPRESENTATIVE U Knauff, IV/'IREL01 y�� @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025(201401)