2019-654-E DEAPR - Tommy Lawrence Electrical electrical work River Park

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DocuSign Envelope ID:02AD3AOB-303A-4240-9F5E-504B725E5AD8 LAWRE-1 OP 1D: BP CERTIFICATE OF LIABILITY INSURANCE DATE IMMlODIYYYY]09/1012019 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 pollcy(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 endorsements. CACT CONTCT NAME: Phillip Allen Thompson-Allen,Inc. PHONE PAX P.O.Box 100 Me Ne E,:336-599-2175 f►uc No:336-599-fi932 Roxboro,NC 27573 A OMAILLSS: Barbara Piper INSURERS AFFORDING COVERAGE NAIc f1 INSURER A:Cincinnati Insurance Company 10677 INSURED Tommy Lawrence Electrical INsuReft a:Cincinnati Casualty Company 29666 Contractor's Inc. P.O. Box 641 INSURERC Roxboro, NC 27573 INSURERD. INSURER E: INSURER F: COVERAGE$ 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 "PIE OF INSURANCE POLICY NUMBER MM10DlYYYY POLICY WD YYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000.00 CLAIMS-MADE OCCUR X EPP 0096783 01/01/2019 01101/2020 PREMISES EeRENTED occurrence S 800,00 ME ExP Ony one person) S 10,000 PERSONAL&AOV INJURY $ 1,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY X AC ❑LOC PRODUCTS•COMPIOP AGG S 2,000,000 OTHER: S AUTDMOBILE LIA61Lt7Y COMBINED SINGLE LIMIT f 1 000,000 Ea accldenl + A x ANY AUTO EBA 0096783 01/01/2019 01/01I2020 BODILY INJURY(Per pefw) S ALL OWNED SCHEDULED BODILY INJURY(Peraccldenl] $ AUTOS AUTOS x X NON•OWNED PR0PERTY DAMAGE $ HIRED AUTOS AUTOS Peracc4 nI 5 x UMBRELLA LIAR Xd OCCUR EACH OCCURRENCE S 5,000,00 * EXCESS LIAS CLAIMS-MADE EPP 0096783 0110112019 01/01/2020 AGGREGATE S 5,000,000 DEO RETENTIONS $ WORKERS COMPENSATION X PER R AND EMPLOYERS'LIABILITY STATUTE ER YIN B ANY OFFICERMEMBER ARTNERIXCLUDED?ECUTIVE N❑NIA EWC 036823E-02 04/01/2019 01/0112020 E.LEACHACCIDENT S 100,00 (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE S 100,00 If yeg,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 600,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,AddItIonal Rom76L5 Schodulo,may be attachod If more apace Is requlrod) Orange County is named as additional insured. 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 ACCO ROAN CE WITH THE POLICY PROVISfONS. P.O. Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE Barbara Piper a 1988-2014 ACORD CORP RATION. All rights reserved. ACORD 2512014101) The ACORD name and Toga are registered marks of ACORD