2019-146-E AMS - BIRS Board of Elections roof

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DocuSign Envelope ID:93D03012-FAF4-4641-AFE7-399DF48FAB9B DATE(MMIDDNYYY) ACC>R" CERTIFICATE OF LIABILITY INSURANCE 1 0/412 0 1 8 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 policyties)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 Ileu of such endorsementis). PRODUCER NAAME: Lynne Meyer,CIC CPIW AIMS Marsh&McLennan Agency LLC PHONE FAX 3625 North Elm St (A1C,No,Ext):336-346-1302 _ Arc No):336-346-1397 Greensboro NC 27455 ADDRESS: Lynne.Meyer@marshmma.com _ INSURERS AFFORbINGCOVERAGE NAIC#_ INSURER .Builders Premier Insurance Company 13036 INSURED BIRSI.2 INsURERB.Columbia Casualty Company 31127 BIRS, Inc. - Mr.Raven Broeker INSURER C:Builders Mutual Insurance Company 10844 PO Box 36197 INSURERD: _ Greensboro NC 27416-6197 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1625434416 REVISION NUMBER: THIS 1S TO CERTrirY 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 ADDL SVBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLJCYNUMBER MMIDD MMMDIYYYY LIMITS A X COMMERCIAL GENE PALLIASILITY PCP0000532 51112DI0 5/1/2019 EACH OCCURRENCE $1.000.000 CLAIMS-MADE [XI P OCCUR REMI'E (RENTED PREMISES Ea Oceurrenca) 5 100,000 MED E](P_( ,y cna person) $5,000 PERSONAL&ADV INJURY 5 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 _ POLIGY F JET LOC PRODUCTS-COMPlOPRGG 52,000,000_ OTHER: $ A AUTOMOBILE LIABILITY PCADD18423 511001 B WV2019 COMBINED SINGLE LIMIT S 1,DD0 000 Ea acoldent I}( ANY AUTO 60DILY INJURY(Per person)) 5 OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS x HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accidenl _ ComplCc0 Dad $1,00011,000 C X UMBRELLALIAS ){ OCCUR MU800012e6 811/2018 511r2019 EACHOCOURRENCE S5,000,00D EXCESS LIAB CLAIMS-MADE AGGREGATE S 5A00,000 DED x RETENTION — ---- -- - - - $ A WORKERS COMPENSATION PWGI00029008 511/2018 6/112019 X PER OTH- AND EMPLOYERS'LIABILITY Y 1 N STATUTE_ ER ANYPROPRIETORIPARTNERIEXECUTIVE ❑ NIA E.L.EACH ACCIDENT 5 1,000,000 OFFICEWMEMBEREXCLUDED7 — tMandatory in NH) E.L.DISEASE-FA EMPLOYEE $1,900,000 If as,descae undar D SCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000 000 A Rental EquipmenI PCP0003632 mr201 a 511120,9 160,000 6 E&O1Polfullon CE06918SS995 511Y2019 5/112019 1,000,00D DESCRIPTION OF OPERATIONS r LOCATIONS l VEHICLES(ACORD 101,Addllfonal Remarks Schedule,may be attached it more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Orange County PO Box 85181 AD ORIZED REPRESENTATIY Hillsborough NC 27278 0 ) � 7 R + CJ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD