2018-709-E AMS - Hillsborough Plumbing Cedar Grove repair

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DocuSign Envelope ID:26463C8C-1673-4776-BEDE-B251C04B9900 - ® DATE IMMfDD1YYYY) C" CERTIFICATE OF LIABILITY INSURANCE 5/8/2018 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 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 PHONalxtl: (919)732-2191 ;a C,No):Ig1g173a-2192 - E-MAIL -.... --- ADDRESS: PO Box. 490 INSURER(S)AFFORDINGCOVERAGE NAIC# HILLSBOROUGH NC 27278 INSURER A:Owners ----32700 INSURED —- - INSURER B; _ ------- Hillsborough Plumbing Company Inc INSURER C: 1020 Nc Highway 57 INSURER D: INSURER E Hillsborough NC 27278-8987 INSURER COVERAGES CERTIFICATE NUMBER:CL18 5 8 0 2 815 REVISION DUMBER; 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, EXC_L_U_S_IONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ............. ..-- ------ --_..-._...ADD —_-- _ --- LTIZ TYPE OF INSURANCE POLICY NUMBER MMJoD1YYYY MMl6 YYYYYY LIMITS X COMMERCIAL GENERAL LIABILITY 1,000,000 EACH OCCURRENCE $ A CLAIMS-MADE I n OCCUR l PREMISES(Eaocc�Errence $ — 300,000 35203246 5/14/2018 5/14/2019 MEDEXP(Anyoneperson) $ 10,000 PERSONAL&ADVINJURY $ 1,000,000 GEI%rLAGGREGATE LIMIT APPLIES PER; GENERAL AGGREGATE S 2,000,000 POLICY JEC7 -- LOG PRODUCTS-COMPIOPAGO S 2,000,000 OTHER: PremiseslOperations $ AUTOMOBILE LIABILITY COa accMBIideNE-nt)SINGLE LIMIT $ 1,000,000 E A R ANY AUTO BODILY INJURY(Per person) $ ALL OWNED ` SCHEDULED 4725694701 5/14/2018 5/14/2019 BODILYINJURY(Peracadent) $ AUTOS AUTOS X HIRED AUTOS X NON-OMED PROPERTY DAMAGE S AUTOS (Per acsdent) WinsuredlLlnderinsured I$ 1,000,000 X �UMBRELLALIAB X OCCLIR F.ACHOCCURRENCE s 5,000,_000 A EXCESS LIAR C_LAIMS-MADE AGGREGATE S 5,000,000 4725694700 5/14/2018 5/14/2019 @ DED X RETENTION$ 14,ODD i s WORKERS COMPENSATION i X PER OTH- ___ AND EMPLOYERS'LIRBILITY Y 1 N STATUTE ER ANY PROPRIF.TOWPARTNEP)FXECUTIVE E,L,EACHACCIDENT 8 1,000,000 A+ M nda OFFICEWMEWER in NH EXCLUDED? n N!A 35041871 5/14/2018 5/14/2019 ; - - -- ��_......... .._ (y ry } E.L.DISEASE-EA EMPLOYE $ T.,040,000 If DESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT 5 1,000 000 I .A. I Leased & Rented 35203246 5/14/2018 5/14/2019 Limit 100,000 Equipment I Deduclible 1,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD i01,Additional Remarks Schedule,may de attached II more space is required) Job: Cedar Grove Building Certificate Holder i.s additional insured with respects to General Liability by signed written contract. l CERTIFICATE HOLDER CANCELLATION abarnes @orangecount:ync.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I 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 MOORE/CARLA 071988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS026(201401) i