2019-406-E DEAPR - Agri-Waste Technology Inc. Twin Creeks soil testing

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DocuSign Envelope ID:4F777F78-922F-43C2-A26A-E4F2744C E FEB AGR{W-1 OP IDO C CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDWYYYY) 06/26/2019 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 HOLDEN. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the po[icy(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 ho[der in lieu of such endorsements . PRODUCER 919-556-3698 coN Acr Don Stroud,CIC,AAI Hartsfield&Nash Agency,Inc. PHONE 919-556-3698 FAx 919-556-8758 Post Office Box 110$ Alc No,Ext: AIC No): Wake Forest,NC 27588 E-MAIbSS0A OR on a s le -nas .Com Don Stroud,CIC,AAI I NS U RERfS1 A FORGING COVERAGE NAIC# INSURER A!SSIeCtlVe Insurance Company 39926 NSIJ INSURER 0;Accident Fund Insurance Co 10166 5 gni�aste Teehnol❑ggYy Inc INSURER c:Endurance American Specialty 41718 01 N.Salem St Ste 203 Apex,NC 27502 INSURER A INSURER E: 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. lLSR Liu TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADE ] OCCUR 52253659 01/18/2019 0111$12020 DAMAGE TO RENTED 300,000 ME EXP(Any one persoN 10,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 4,000,000 POLICY X jEE LOC PRODUCTS-COMPIOP AGG 4,000,000 OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 X ANY AUTO S2253659 01/18/2019 01/18/2020 BODILY INJURY Per ermn S OWNED SCHEDULED AUTOS ONLY AU❑❑IT�O$$ pp BODILY INJURY Per acc[dent AHIITOS ONLY Al1TO5fY PPerOaoEcitlent AMAGE A X UMBRELLA LIAB x OCCUR EACH OCCURRENCE 2,000,000 EXCE sLIAB CLAIMS-MADE S2253659 01IM812019 01/18/2020 AGGREGATE 2,000,000 DE0 I X I RETENTIONS 0 B WORKERS COMPENSATION X PER OTH- ANDEMPLOYERS'LIABILITY WCV6138339 01/18/2019 01/18/2020 1,000,000 ANY PROPRIETORIPARTNERIEXECUTIVE Y! E.L.EACH ACCIDENT QFFICERIMEMBER EXCLUDE❑7 N N++4 andataryinN y E.L.DISFASE-EAEMPL YE 1 1,000,000 It as,describe under 11000,000 ❑ CRIPTI N OF OPERATIONS below E.L.DISEASE-POLICY LIMIT C Professional Liab ECC10101303500 0812212018 0812212019 Per Claim 4,000,000 A LeasedlRented S2253659 0111812019 0111812020 Equipment 25,000 DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(ACORD 101.Additional Remarks Schedule,may he attached if more space is required) CERTIFICATE HOLDER CANCELLATION ORAN818 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County QEAPR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 tY ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 306 A Revere Road Hillsborough, INC 27278 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD