2019-008-E AMS - Warren Hay Seymour Center HVAC

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DocuSign Envelope ID:84745391-03D8-4DO6-B5CO-65118D889FOD DocuSign Envelope ID:9ADC47E5-1DA5-49A9-ADC8-76352A593CBF ® DATE AC� .- �� CERTIFICATE 4F LIABILITY INSURANCE 12/5/2017 THIS CERTIFICATE IS ISSUED AS A!NATTER 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 BOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATEON IS WAIVED,subject to the terms and conditions of the poll Icy,certain p01Icles 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: Business Insurers of Carolinas PHONE (919)968-4611 FAX e.[919)968-8991 800 Eastowne Drive, Suite 208 0.MAIOPMESS�cirelandebu sine ss-insurers.GCLn PO Box 2536 INSURER S AFFORDING COVERAGE NAIC# Chapel Hill NC 27515-2536 INSURERA:Penn National Ins. Companies 14990 INSURED INSURER a:3rid afield Casualty Insurance 10335 Warren-Hay Mechanical Contractors Inc INSURER C Sheet Metal Duct Suppl iris LLC INSURER D: PO Box 818 INSURER E Hillsborough NC 27278 INSURERF: COVERAGES CERTIFICATE NUMBER.CL1712520606 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- ILTR TYPE OF 1HSORANCE ADO S R POLICY EFF PDLICY EXP LIMITS1=Ion NUMBER D!Y MMIDD Y X COMMERCIAL GENERAL LIAMLITY EACH OCCURRENCE $ 1,000,000 A 1 CLAIMS-MADE x OCCUR IS TOR 100 000 PREMISES R oucurrenoe $ r CX90726312 12/31/2017 12/31/2018 MED EXP Wq one person $ 10,000 _ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 x POLICY❑JECO7 ❑LOG PRODUCTS-COMP/OP AGG 2,000,000 OTHER: $ AUTOMOBILE LIABILITY � INEEDD SINGLE LIMIT $ 1,000,000 A X ANY AUTO BODILY INJURY;Par person} S ALL OWNED SCHEDULED Ax90726312 12/31/2017 12/31/2018 BODILY INJURY(Per accidenq $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE A HIRED ALITOS X AUTOS Per a- ent) I EWDnements - $ --- X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,0001 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED I I RETENTION$ UL90726312 12/31/2017 12/31/2010 $ WORKERS COMPENSATION X FERR E OTH- AND EMPLOYERS'LIABILITY Y 1 N STATLIT '- AOtFJYH. ERRrIEMBER EXCLUDEDUT� N rA EL EACH ACCIDENT 1 500,000 B (Mandatory In NH) 0196-40173 12/31/2D17 12/31/2018 E,LOISEME-F.A EMPLOYEE $ 500,000 If yyees,describe under DES{;RPATION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 A Leased/Rented Equipment CX90726312 12/31/2017 12/31/2018 LIMIT $50,0DO DEDUCTIBLE $500 nESCRIPnoN or OPERATIONS f LOCATIONS I VEHICLES ZACORD 101,Additional Remarks Schedule,may he attached it ntore space N required) CERTIFICATE HOLDER CANCELLATION abarnes@orangecountync.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 6181 ACCORDANCE WITH THE POLICY PROVISIONS. Hi-Ilsboroughr NC 27278 AUTHORIZED REPRESENTATIVE J Knauff, 'IV/IREL01 01988-2014 AGORD CORPORATION, All rights reserved. AGORD 25(2014101) The AGORD name and Toga are registered marks of AGORD INSU25(201401)