2019-613-E Solid Waste - Rice Glass Company scalehouse

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DocuSign Envelope ID:8F96EDOD-E6B2-41 E8-A560-4BC381 EC1 DE6 Aca'aCERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD;YYYY) 0 811 512 0 1 a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND 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($),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 CONTACT NAME: Diane Nadeau Business Insurers of Carolinas PHONE (919}966-4611 AX (91a}968-8991 RIC No Fxtll A!C No 600 Eastowne Drive,Suite 206 ADDRESS: dnadeau@business-insurers.com PO Box 2536 IN SURER(S)A FFORDI N 0 COVERAGE NAIC* Chapel Hill NC 27515.2536 INSURERA; Union Insurance Company 25844 INSURED INSURER 8; Accident Fund Insurance Co of Arne rlca 10166 Rlee's Class Company,Inc. INSURER C: PO Box 40 INSURER D INSURER E: Carrboro NC 27510 1 INSURER F; COVERAGES CERTIFICATE NUMBER: 18-19 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 CONTRACTOR 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. ILTR TYPE OF INSURANCE iN O POLICY NUM DER MMIDDIYYYY MMlDDIYYYY UMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE �OCCUR PREMISES Ea occurrence 8 500,000 MED EXP(Any one person s 10,000 A CPA4349078 09/23/2018 09)23/2019 PERSONA LdADV INJURY s 1,000,000 GEN'L AGO REGATE LIMITAPPLIES PER; G ENER AL AGGREGATE $ 2,000,000 POLICY PRO- LOC. 2,000,000 JECT PRODUCTS-COMPIOPAGG S OTHER 5 AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT a 1,000.000 Ea accident x ANYAUTO BODILY INJURY(Per person) $ A OWNED SCHEDULED CPA4349078 09/23/2016 D912V2019 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMA $ AUTOS ONLY AUTOS ONLY Per acCideM Uninsured motorist s 1.000,000 X UMBRELLA LIAR OCCUR EACH OCCURRENCE y 5,000,000 A EXCESS UAB -- HCLAIMS-MADE CPA4349078 09/2312018 09/23/2019 AGGREGATE S 5,000,000 DE❑ I I RETENTION 3 S WORKERS COMPENSATION X1 STATUTE ERH AND EMPLOYERS'LIABILITY YIN ANY PROPRIETCRIPARTNEWEXECUTIVE 1,000,000 B OFFICERIMEMBER EXCLUDED? NIA VVCV6133066 09123/2018 09123I201$ E.L.EACH ACCIDENT E (Mandatory in NH) E.LOISEASE-EA£MPLOYEE S 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1.000,000 DESCRIPTION OF OPERATIONS 1 LOCATION51 VEHICLES(ACORD 101,Additional Remarks S(;hedule,may be attached If more space is required} CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS. P.O.box 17177 AUTHORIZED RF,P R E SE N TATIVE Chapel Hill NC 27516 n Q 1988.2015 ACORD CORPORATION. All rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD