2019-056-E AMS - Intellicom ES cabling

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DocuSign Envelope ID:277C13A8-9A1A-4D58-A232-848A3869DB85 ® DATE(MMIDDIYYYY) AC CERTIFICATE F LIABILITY INSURANCE 4/l/2015 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 Steven Stacy y Pelnik Insurance PHONE (919)459-8000 (,AX No:(919)959-8019 100 Ridgeview Drive ADDRESS:Steve.Stacy@Pelnik.corn Suite 100 INSURERS AFFORDING COVERAGE NAIC# Cary NC 27511 INSURERA:Selective Insurance INSURED INSURER B:Builders Mutual Insurance Co 10844 Intellicom Inc. INSURER C: 2902 S Miami Blvd Ste C INSURER D: INSURER E: Durham NC 27703 1 INSURER F COVERAGES CERTIFICATE NUMBER:CL154112016 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 D POLICY NUMBER MMIDD/YYYY MM/DD/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED A CLAIMS-MADE Y OCCUR -PREMISES Ea occurrence $ 100,000 S 2162397 4/1/2015 4/1/2016 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICY PRO- F-]JECT ❑LOC PRODUCTS-COMP/OPAGG $ 3,000,000 OTHER: Employee Benefits $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident A X ANY AUTO BODILY INJURY(Per person) $ ALL UTOS OS AUTOS SCHEDULED AU S 2162397 4/1/2015 4/1/2016 BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ IAUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 6,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 6,000,000 DED RETENTION$ S 2162397 4/1/2015 4/1/2016 $ WORKERS COMPENSATION }[ AND EMPLOYERS'LIABILITY Y/N STATUTE OER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBE B (Mandatory in NH)EXCLUDED? PWC1010380-TEMP 4/1/2015 4/1/2016 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) { 1 CERTIFICATE HOLDER CANCELLATION (919)644-3324 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Department of Purchasing THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN & Central Services ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE I Steven Stacy/STAGY ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(901401)