2019-575-E AMS - Hepaco courthouse stormwater cleanout

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DocuSign Envelope ID:58936744-93CF-49DD-8E3B-8686F5361 F84 DATE(MM/DD/YYYY) ACa1zo® CERTIFICATE OF LIABILITY INSURANCEF9/30/2019 9/26/2018 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 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 lieu of such endorsement(s). PRODUCER Lockton Insurance Brokers,LLC CONTACT NAME: 777 S.Figueroa Street,52nd Fl. PHONE FAX CA License#OF 15767 E MAILo Ext: A/C No Los Angeles CA 90017 ADDRESS: (213)689-0065 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Everest Indernnity Insurance Company 10851 INSURED HEPACO,LLC INSURER B:Zurich American Insurance Company 16535 1454970 9335 Harris Corner's Parkway,Suite 220 INSURER C:AXIS Surplus Insurance Company 26620 Charlotte NC 28269 INSURER D: INSURER E: INSURER F: COVERAGES HEPACOI CERTIFICATE NUMBER: 15636892 REVISION NUMBER: XXXXXXX 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 POLICY NUMBER MM/DDIYYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY N N EFlML00039-181 10/1/2018 10/1/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FxI OCCUR PREM SES Ea occu ence $ 300,000 MED EXP(Any one person) $ 25,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY[X]JE� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY N N BAP013676005 9/30/2018 9/30/2019 (CO aBINEDtSINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS XXXXXXX HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY Per accident Com /Coll DED $ 2,500 A UMBRELLA LIAB X OCCUR N N EFlCU00028-181 10/1/2018 10/1/2019 EACH OCCURRENCE $ 20,000,000 C X EXCESS LIAB CLAIMS-MADE ELZ633359012018 10/1/2018 10/1/2019 AGGREGATE $ 20,000,000 DED RETENTION$ $ XXXXXXX WORKERS COMPENSATION PER OTH- B AND EMPLOYERS'LIABILITY N WC013676106 10/1/2018 10/1/2019 X S Y/N TATUTE ER ANY PROPRIETOR/PARTNER/EXEWINE N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Professional Liab N N EFIML00039-181 10/1/2018 10/l/2019 $11,000,000 Each Incident/Agg A Contractor's Pollution Liab EF1ML00039-181. 10/1/2018 10/1/2019 $11,000,000 Each Incident/Agg DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 15636892 Orange County North Carolina Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Attn:Alan Dorman THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O.BOX 8181 (200 S.Cameron Street) Hillsborough NC 27278 AUTHORIZED REPR 7 ©1 88-201 AC D CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD