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2019-012-E AMS - Intellicom Whitted ES cables
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2019-012-E AMS - Intellicom Whitted ES cables
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Last modified
1/22/2019 10:53:43 AM
Creation date
1/9/2019 11:52:36 AM
Metadata
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Template:
Contract
Date
11/12/2018
Contract Starting Date
11/19/2018
Contract Ending Date
12/31/2018
Contract Document Type
Contract
Amount
$2,560.00
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R 2019-012 AMS - Intellicom Whitted ES cables
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2019
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DocuSign Envelope ID:04DB30E9-D54D-4F95-8391-C9A6A248DC20 <br /> DATE(MM/DD/YYYY) <br /> A�" CERTIFICATE OF LIABILITY INSURANCE <br /> 01/02/2019 <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Steven Stacy <br /> NAME: <br /> Pelnik Insurance PHONE (g19)459-8000 FAX (866)714-3576 <br /> A/C No Ext: A/C,No): <br /> 100 Ridgeview Drive E-MAIL Steve.Stacy@Pelnik.com <br /> ADDRESS: <br /> Suite 100 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Cary NC 27511 INSURERA: Selective Ins Co of America 12572 <br /> INSURED INSURER B: Builders Mutual Insurance Co 10844 <br /> INTELLICOM INC AND PLC COMMUNICATIONS,INC INSURERC: <br /> 2902 S MIAMI BLVD STE C INSURER D: <br /> INSURER E: <br /> DURHAM NC 27703-9042 1INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CL1832816358 REVISION NUMBER: <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 /> INSR TYPE OF INSURANCEADDLSUBR POLICY EFF POLICY EXP <br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR PREM SES Ea oNcE ante $ 500,000 <br /> MED EXP(Any one person) $ 15,000 <br /> A X Includes Contractual Liab. S 2162397 04/01/2018 04/01/2019 PERSONAL&ADV INJURY $ 1,000,000 <br /> MOTHER <br /> LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 <br /> POLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 3,00<7,O170 <br /> JECT: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> Ea accident <br /> X ANYAUTO BODILY INJURY(Per person) $ <br /> A OWNED SCHEDULED S 2162397 04/01/2018 04/01/2019 BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> X HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY /� AUTOS ONLY Per accident <br /> Auto Elite Pac $ <br /> X UMBRELLA LIAB M <br /> OCCUR EACH OCCURRENCE $ 6,000,000 <br /> A EXCESS LABCLAIMS-MADE S 2162397 04/01/2018 04/01/2019 AGGREGATE $ 6,000,000 <br /> DED I X1 RETENTION $ $ <br /> WORKERS COMPENSATION X I <br /> STATUTE EREIR H <br /> AND EMPLOYERS'LIABILITY Y/N 1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> B OFFICER/MEMBER EXCLUDED? NIA PWC1010380 03 04/01/2018 04/01/2019 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Employee Dishonesty/Crime Limit 100,000 <br /> A Leased/Barrowed Equipment S 2162397 04/01/2018 04/01/2019 Limit 100,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />
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