2019-703-E AMS - Warren Hay Contract Boiler Replacement Southern Human Services 15868 DSF

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DocuSign Envelope ID:7BOB2B82-F1AO-422B-8780-5A55AE1F554A c DATE I MMfDDIYYYYI ACaR10 CERTIFICATE OF LIABILITY INSURANCE 1 212 81201 8 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 CONTACT Crystal Ireland NAME: ry Business Insurers of Carolinas PHCNE {91%968-4611 FAX (919)968-8991 AIC No Ext: AIC Nd 800 Eastowne Drive,Suite 208 AooREsS: cireland®business-insurers.com PO Box 2536 INS URER{SI AFFORDING COVERAGE NAIC 0 Chapel Hill NC 27515-2536 INSURER A: Acadia Insurance Company 31325 INSURED INSURER B: Bridgeffeld Casualty 10335 Warren-Hay Mechanical Contractors Inc INSURER C: Sheet Metal Duct Suppliers LLC INSURER D: PO Box 818 INSURER E: Hillsborough NO 27278 INSURER F: COVERAGES CERTIFICATE NUMBER: CL1 81 22824 327 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO 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 ARID CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDWYYYY MMICOIYYYY LIMITS x COMMERCIAL GENERAL LIABILITY 1,000.000 EACH OCCURRENCE S CLAIMS-MADE �OCCUR PREMISES Ea occurrence S 100,000 MED EXP(Any one person) S 10.000 A CPA4429328 12/31/2018 12J3112019 PERSONAL&AUV INJURY s 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000.000 �JC POLICY Eg JE a LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: $ I L AUTOMOBILE LIAB B NED N E LIMITILITY Ea accident) $ 1,000,000 x ANY AUTO BODILY INJURY(Per person) S A OWNED SCHEDULED CPA4429328 12J3112018 12/31/2019 BODILY INJURY IPeracddent) S AUTOS ONLY AUTOS x HIRED IX NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Par aaideM Endorsements $ X UMBRELLA LIAS OOCUR EACH OCCURRENCE s 3,000,0DD A EXCESS LIAS CLAIMS-MADE CPA4429328 12/31/2018 12131/2019 AGGREGATE s 3,000,000 OED I I RETENTIONS I $ WORKERS COMPENSATION x PER .x OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN 500.000 B ANY CERIMEETORIPARTN0EDXECUTIVE NIA 0198-40173 12/3112018 12131J2019 E.L EACH ACCIDENT S OFF ICERIMEMBER ExGLUOEO? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s 500.000 It yes,describe under 500.000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ LeasedlRented Equipment LIMIT $50,000 A Installation Floater CPA4429328 12/31/2018 12131/2019 LIMIT $500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACCRD 101,Additional Remarks Schedule,may be attached If more space is requ Ire dl CERTIFICATE HOLDER CANCELLATION 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. PO Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough NC 27276 49 �c7 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD