2019-156-E AMS - Environmental Solutions Group air and surface testing ES

Browse Search

DocuSign Envelope ID: EE36A5A6-7D04-4876-B67B-1CB28B880BC7 A� © ril/30/2019 TE(MMMIDNYYY) CC CERTIFICATE OF LIABILITY INSURANCE 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 Ph llis Carter, CIC, CISR NAME: Y Craft Insurance Center PHONE (336)375-0600 FAx No):(336)375-7004 823 North Elm Street E-MAIL ADDRESS:p carter@craftinsurance.oam PO BOX 14946 INSURERS AFFORDING COVERAGE NAIL N Greensboro NC 27415 INSURER �010n Insurance Company 39993 INSURED INsuRER B:Selective Ins. Co. Of America 12572 ESG Holdings, Inc. INSURERc Accident Fund National Insurance 12305 See Named Insured Attachment INSURER D: 7 Maple Leaf Drive, Suite 104 INSURERE: Greensboro NC 27410 INSURER F: 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 #SSUED 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. INTR TYPE OF INSURANCE AD L BR POLICPOLICY NUMBER MMIODY Err IYYYY POLICY Y LIMITS X COMMERCSAL GENERAL LIABILITY 1,000,000 _ EACH OCCURRENCE $ A X OCCUR DAMAGE TO RENTED 50 ❑00 PRE CLAIMS-MADE MISES Ea occurrence $ + FACEP3066172 1/31/2019 1/31/202D MED EXP(Any one person) S 5,000 _ PERSONAL&ADV INJ U RY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY _. PRO JECT ^� LOC PRODUCTS-COMPIOP AGG $ 2,000r000 OTHER: $ AUTOMOBILE LIABILITY COMBINER SINGLE LIMIT $ 1,000,000 B X ANY AUTO BODILY INJURY(Per parson) $ FAUOSS AUTOS O SCHEDULED AUTOS S2194934 1/31/2D19 1/31/2020 BODILY INJURY(Per socldent) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ r MBRELLA LIAR XOCCUR EACH OCCURRENCE $ 1 DOO 000 AEXCESS LIAR CLAIMS-MADE AGGREGATE $ 1,000,000 DIED X RETENTIONS —3&D00 EXC3045002 1/31/2019 1/31/2020 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIA9ILrrY YIN STATUTE ER ANY PROPRIETOWPARTNERIEXECUTIVE i N 1A C E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NCV6122801 03 1/31/2019 1/31/2020 E.L.DISEASE-EA EMPLOYE $ 1 DOD DOD H s,descrihe under DI SCRIPTION OF OPERATIONS Wew E.L.DISEASE-POLICY LIMIT I$ 1,000,000 A Professional E&O PMMP3066172 11/31/2019 1/31/2020 Occurrence/Aggregate $1M/$2M A pollution PACEP3066172 1/31/2D19 1/31/2020 OccurrencelAggregate $1M/$2M ❑ESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101.Additional Roma rks Schedule,may he attached if morn spa Ca 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 2727E AUTHORIZED REPRESENTATIVE P Carter, CIC, CISR/P �l 0 1 988-201 4 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD IN,sn?s r�rrsentt