2019-398-E AMS - Olive Hill Welding jail shower repair

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DocuSign Envelope ID:298C6E01-9C5E-4A68-8600-AF85E503B99D OLIVE-3 OP ID: BP ACORO 706127/2019 [MM1bb1YYYY) �� CERTIFICATE OF LIABILITY INSURANCE (MMID IYY 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 1S 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 endorsements . PRODUCER NAME CT Phillip Allen Thompson-Allen,Inc. PHONE FAX P.O.Box 100 AIC Na Er<t:336-599-2175 (AID, AIC NO); 336-599-6932 Roxboro,NC 27573 E.MA1L Barbara Piper ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A.Cincinnati Insurance Company 10677 INSURED Olive Hill Welding and INSURER 8:Cincinnati Indemnity Company 23280 1940 Semora Rd. INSURERC: 13037 Roxboro, NC 27574 INSURER D; INSURER IS: 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 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 E TYPE OF INSURANCE GL SUB Mf POLICY NUMBER MpplYYYY MMiDD YY LTR YY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A AG-To ICLAIMS-MADE OCCUR ENP 389573 07l46l2018 07/06/2019 PREMISES Ea occurrence $ 100,000 MEO EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 POLICY PRO ❑ LOC JECT PRODUCTS-COMPIOPAGG $ 1,000,000 OTHER $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident) A X ANY AUTO ENP 389573 07106/2018 07/0612019 800ILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE 'CAP 6133608 07/0612018 07106/2019 AGGREGATE $ 2,000,00 _�DEIT RETENTION$ $ WORKERS COMPENSATIONER OTH. AND EMPLOYERS'LIABILITY STATUTE ER B ANY PROPRIETORIPARTNERIEXECUTIVE YIN EWC0389586 07/06/2018 07/06/2019 E.L.EACH ACCIDENT $ 500,00 OFFICERWEMBEREXCLUDED? N!A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 500,000 O CSU CSU 0072193 07/06/2018 07/0612019 Umbrella 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION ORANGEC 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. P.O. Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE Barbara Piper ©1988-2014 ACORD CORP RATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD