2016-743-E AMS - Penn Davis Coatings EMS painting

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DocuSign Envelope ID:24485349-1 FD849130-AAD2-75=446130C DATE IMMIDDIYYYYI A`�V CERTIFICATE OF LIABILITY INSURANCE 91912{)16 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 E. Heidi Morse Jones Insurance Agency Inc. PHONE 820 Benson Road 919-772-0233 PAx 919-779-4025 IAX N°-F- Garner NC 27529 E-MAIL .heidim@ajones-insurance.com -- INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:Cincinnati Insurance Companry._ __ _ 10677 INSURED PENNDAV-01 INSURER B:Builders Premier Insurance Co 13036 Penn Davis Coatings,Inc. INSURER C P O Box 575 - Garner NC 27529 INSURERD: INSURERE: INSURER F COVERAGES CERTIFICATE NUMBER:1551488639 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 POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS - LT3t NSD N o POLICY NUMBER M IDDfYYYY MMIDDfYYYY A X COMMERC'IALGENERALLIABILITY EPP0226481 1125/2016 1/25/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE x OCCUR PREMISES(Ea accu ca 5500,000 --- MED E P(Any one arson 510,000, PERSONAL 8 ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000.000 POLICY[X]I JE O u LOG PRODUCTS-COM Plop AGG $2,000,000 OTHER: $ A AUTOMOBILE LIADILITY EBA02264$1 112512016 112512017 COMBINED NINGL Ea accIdenQ $1,0OO,ODO X ANY AUTO BODILY INJURY(Per perwn) $ __ pyy� LX AILJTOSEDSCHEDULED BODILY INJURY(Per accident) $ X HIRED AUTOS AUTOS NONOWNED PROPERTY DA $ - AUTOS (Per acdden0 A X UMBRELLA LIAR X OCCUR EPP02264$1 1125/2016 112512017 EACH OCCURRENCE $5,GW,000 EXCESS LIAR CLAIMS-MADE AGGREGATE y5,000,000 DED X RETENTIONSO - $-- �- B WORKERS COMPENSATION PWC 0020810 17 1/1/2016 1/112017 X STA UTE OT ER" ANG FMPLOYERS'LIABILITY YlN ANY PR}PRIETOPJPARTNEWExECUTIVE N 1 A E.L.EACH ACCIDENT S 1,000,0D0 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under --- _ DESCRIPTION OF OPERATIONS)slow E.L.DISEASE-POLICY LIMIT S 1,000,DDD A Rented/Leased Equipment EPP0226451 V2512016 1125/2017 Limit ACV 80,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD IU1,Addillonal Remarks Schedule,may be attached if mom space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRI9ED 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 All ORfZEO REPRESENTATIVE O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD i