2017-733-E AMS - Hillsborough Plumbing CGCC toilets

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DocuSign Envelope ID:8FE8324A-1 D38-4527-981 D-AB69DEC1 ED82 J�C RL7® DATE(MWDDIYYYYI CERTIFICATE OF LIABILITY INSURANCE 5/11/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE NOES 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 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 NAME: Colonial Insurance Agency Hillsborough PHONE 4919)732-2191 FAXAfCNo (919)732-2192 -MAIL _..--- ADDRESS: PO Sox 490 INSURE S AFFORDING COVERAGE NAIC N HILLSBOROUGH NC 27278 INSURERA:Owners 32700 INSURED INSURER B; Hillsborough Plumbing Company Inc INSURERC. 1.020 Na Highway 57 INSURERD.* INSURER E: Hillsborough NC 27278-8987 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1751102196 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 POLI LIES.LIMITS SHOWN MAY HAVE BEEN REDO GED BY PAID CLAIMS, INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MWDD MWDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE I n l OCCUR DAMAGE TORENTED 300,000 PREMISES Ea occunrenoaj X 35201246 5/14/2017 5/14/2010 MEDEXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000,000 X POLICY❑PRO- ❑ ,000,000 2 JECT LOC PRODUCTS-COMPIDPAGG $ OTHER: Premfsesloperabons- --- $ CO M BINE INGLE LIMIT AUTOMOBILE LIABILITYD $ 1,000,000 _[Ea aCCtdentl ...-_.-_-- A X ANY AUTO BODILY INJURY(Per person) $ ALLOYNNED SCHEDULED 4725694701 5/14/2017 5/14/2018 BODILY INJURY(Peraccident) $ AUTOS AUTOS _ NON.OVMEO ROPERTYPer soddent AMAGE $ . HIRED AUTOS AUTOS UMnsured/Underinsured $ 1,000,000 X UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ .5,000,000 A EXCESSLIAB CLAIMS-MADE AGGREGATE $ 5,000,000 DED X RETENTIONS 10 000 4725694700 5/14/2017 5/14/2018 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNEWEXECUTNE E.L.EACH ACCIDENT _ $ _ 1,000,000 A OFFICEFUMEMBER EXCLUDED? N I A (Mandatory In NH) 35041871 5/14/2017 5/14/2018 E.L.DISEASE-EA EMPLOYE $ 1,000,000 r yes,describe under DESCRIPTION OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT $ 1,000,000 A Leased & Rented 35203246 5/14/2017 5/14/2018 Limit 50,000 Equipment Deduchble 1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additlonal Remarks Schedule,may be atlaehed it more space is required) Certificate Holder is additional insured with ]respects to General Liability by signed written contract before a loss. CERTIFICATE BOLDER CANCELLATION areinert@orangecountync.go SHOULD ANY OF THI-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. Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE CARLA MOORS/CARER 01988-2014 ACORD CORPORATION. All rights reserved. ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD INS625 r�nlaml