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2018-742-E AMS - Environmental Solutions Group 510 Meadowlands Air Surface Sampling
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2018-742-E AMS - Environmental Solutions Group 510 Meadowlands Air Surface Sampling
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Last modified
11/26/2018 11:38:06 AM
Creation date
11/26/2018 11:30:17 AM
Metadata
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Template:
Contract
Date
10/31/2018
Contract Starting Date
10/31/2018
Contract Ending Date
12/31/2018
Contract Document Type
Contract
Amount
$2,500.00
Document Relationships
R 2018-742 AMS - 510 Meadowlands Air Surface Sampling
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2018
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TheACORDnameandlogoareregisteredmarksof ACORD <br />CERTIFICATE HOLDER <br />©1988-2014ACORDCORPORATION.Allrightsreserved. <br />ACORD25(2014/01) <br />AUTHORIZED REPRESENTATIVE <br />CANCELLATION <br />DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE <br />LOCJECT <br />PRO-POLICY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />OCCURCLAIMS-MADE <br />COMMERCIAL GENERAL LIABILITY <br />PREMISES(Eaoccurrence)$ <br />DAMAGE TO RENTED <br />EACHOCCURRENCE$ <br />MEDEXP(Anyoneperson)$ <br />PERSONAL&ADVINJURY$ <br />GENERAL AGGREGATE$ <br />PRODUCTS - COMP/OP AGG$ <br />$RETENTIONDED <br />CLAIMS-MADE <br />OCCUR <br />$ <br />AGGREGATE$ <br />EACHOCCURRENCE$UMBRELLA LIAB <br />EXCESS LIAB <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />INSR <br />LTR TYPE OF INSURANCE POLICY NUMBER <br />POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY)LIMITS <br />PER <br />STATUTE <br />OTH- <br />ER <br />E.L.EACHACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />$ <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />Ifyes,describe under <br />DESCRIPTION OF OPERATIONS below <br />(Mandatory in NH) <br />OFFICER/MEMBER EXCLUDED? <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALLOWNED SCHEDULED <br />HIRED AUTOS <br />NON-OWNED <br />AUTOSAUTOS <br />AUTOS <br />COMBINED SINGLE LIMIT <br />BODILYINJURY(Perperson) <br />BODILYINJURY (Peraccident) <br />PROPERTY DAMAGE $ <br />$ <br />$ <br />$ <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSD <br />ADDL <br />WVD <br />SUBR <br />N / A <br />$ <br />$ <br />(Eaaccident) <br />(Peraccident) <br />OTHER: <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE 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 INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT:If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />COVERAGESCERTIFICATENUMBER:REVISION NUMBER: <br />INSURED <br />PHONE <br />(A/C, No, Ext): <br />PRODUCER <br />ADDRESS: <br />E-MAIL <br />FAX <br />(A/C, No): <br />CONTACT <br />NAME: <br />NAIC# <br />INSURER A : <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />INSURER(S)AFFORDINGCOVERAGE <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />INS025 (201401) <br />3/1/2018 <br />Craft Insurance Center <br />823 North Elm Street <br />PO Box 14946 <br />GreensboroNC27415 <br />Phyllis Carter, CIC, CISR <br />(336)375-0600 (336)375-7004 <br />pcarter@craftinsurance.com <br />ESG Holdings, Inc. <br />(see attached for named insured) <br />1000 North Elm Street <br />GreensboroNC27401 <br />Colony Insurance Company39993 <br />Selective Ins. Co. Of America12572 <br />Accident Fund National Insurance12305 <br />A <br />X <br />X <br />X <br />PACEP30661711/31/20181/31/2019 <br />1,000,000 <br />50,000 <br />5,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />B X <br />S21949341/31/20181/31/2019 <br />1,000,000 <br />A <br />XX <br />X 10,000 EXC3045001 1/31/2018 1/31/2019 <br />3,000,000 <br />3,000,000 <br />C Y <br />WCV6122801 1/31/2018 1/31/2019 <br />X <br />1,000,000 <br />1,000,000 <br />1,000,000 <br />A Professional E&O PACEP30661711/31/20181/31/2019 Occurrence/Aggregate $1M/$2M <br />A Pollution PACEP30661711/31/20181/31/2019 Occurrence/Aggregate $1M/$2M <br />P Carter, CIC, CISR/P <br />Orange County <br />PO Box 8181 <br />306-F Revere road <br />Hillsborough, NC 27278 <br />abarnes@orangecountync.gov <br />DocuSign Envelope ID: 5B70C692-11A9-448C-AE82-FE3D3672CB3A
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