2019-010-E AMS - ESG surface and air sampling testing for Link building

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DocuSign Envelope ID:COFFFEC3-61D5-446A-B969-A61327D203D9 F__DATE(MM/DD/YYYY) ACC?" CERTIFICATE OF LIABILITY INSURANCE 3/1/2018 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 Phyllis Carter, CIC, CISR NAME: Y Craft Insurance Center VHCNNo Ext: (336)375-0600 F IC No: (336)375-7009 823 North Elm Street E-MAIL ADDRESS:Pcarter@craftinsurance.com PO BOX 14946 INSURER(S)AFFORDING COVERAGE NAIC# Greensboro NC 27415 INSURERA:Colony Insurance Company 39993 INSURED INSURER B:Selective Ins. Co. Of America 12572 ESG Holdings, Inc. INSURER C.-Accident Fund National Insurance 12305 (see attached for named insured) INSURER D: 1000 North Elm Street INSURERE: Greensboro NC 27401 INSURERF: COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR SD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DA AGE To RENTED A CLAIMS-MADE FX7 OCCUR PRE M IS ES Ea occurrence) $ 50,000 PACEP3066171 1/31/2018 1/31/2019 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PRO- JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY CEa OMBINED ccidentS INGLE LIMIT $ 1,000,000 a X ANY AUTO BODILY INJURY(Per person) $ 13 ALL OWNED SCHEDULED AUTOS AUTOS 52194939 1/31/2018 1/31/2019 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 3,000,000 DED X RETENTION$ 10,000 EXC3045001 1/31/2018 1/31/2019 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A C (Mandatory in NH) WCV6122801 1/31/2018 1/31/2019 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Professional E&O PACEP3066171 1/31/2018 1/31/2019 Occurrence/Aggregate $1M/$2M A Pollution PACEP3066171 1/31/2018 1/31/2019 Occurrence/Aggregate $1M/$2M DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is 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 8181 ACCORDANCE WITH THE POLICY PROVISIONS. 306-F Revere road Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE P Carter, CIC, CISR/P ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025rgmami