2019-029-E AMS - WXProofing Link building sealing

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DocuSign Envelope ID:5F8D875E-969F-44D2-B301-E6E756DDE589 AC�RDa DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 09/26/2010 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 IfNSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(ies)must have ADDITIONAL INSURED provisions or 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 Robin Turner NAME: Reiafion Insurance Services of!North Carolina.Inc. (A ICC.N E:1: (338)855-7829 Arc No): (336)907-2173 4900 Koger Blvd ADDRESS: robin.turner®relationinsurance.com Suite 450 INSURERS)AFFORDING COVERAGE NAIC# Greensboro NC 274D7 INSURER : Capitol Specialty Insurance CO 10328 INSURED INSURER B: Ohio Security Insurance Co 24082 WxProofing,LLC INSURER C• Ohio Casualty Insurance Co 24074 INSURER D PO Box BD30 INSURER E: Greensboro NC 27419 INSURER F COVERAGES CERTIFICATE NUMBER: 18119 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER M MID DrYYYY M MID DIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FxR OCCUR PREMISES Ea occurrence $ 1001000 ME EXP(Any oneperson) $ 5,000 A X, Pollution Liability Y CT2017215102 10/01/2018 10/01/2019 PERSONAL BADVINJURY S 1,000,000 GEhrLAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2.000,000 POLICY E° El LOC PRODUCTS-COMPIOPAGG s 2,000,000 OTHER: Pollution Liability S 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accidant 'X ANY AUTO BODILY INJURY(Per person) $ B OWNED SCHEDULED y BAS58242107 1 DI0112D18 10/01/2019 ROD]LY INJURY(Peraoddent) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE K AUTOS ONLY X AUTOS ONLY Per accldent $ a �( UMBRELLA LIAR X[CLAIMS-MADE OCCUR EACH OCCURRENCE 3 5,000.000 A EXCESS LIAR Y EV2017215902 10/01/2018 10/01/2019 AGGREGATE 3 5,000,000 ❑ED I I RETENTION$ $ WORKERS COMPENSATION x SER ERH AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ 1,000.000 B OFFICER/MEMBER EXCLUDED? N 1A XW55815791 fi 10101l2018 10l01l2019 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE S Iryea,daccaba undcr 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S Leased/Rented Equipment LeasedlRented Property 100,000 C. EM059048027 10/01/2018 10/0112019 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached irmore space Is required) Orange County is included as an Additional Insured with regard to General,Auto and Um b re I WE xcess Liability as required by contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE PO Box 8181 Hillsborough NC 27278 d 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD