Orange County NC Website
DocuSign Envelope ID: 1C76B5BC-4DDA-44DB-BD96-CB4A30946D50 <br /> c DATE I MMfDDIYYYYI <br /> ACaR10 CERTIFICATE OF LIABILITY INSURANCE <br /> 1 212 81201 8 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in Ileu of such endorsement(s). <br /> PRODUCER CONTACT Crystal Ireland <br /> NAME: <br /> Business Insurers of Carolinas PHONE {91%968-4611 FAX (919)968-8991 <br /> AIC No Ext: AIC Nd <br /> 800 Eastowne Drive,Suite 208 AooREsS: cireland®business-insurers.com <br /> PO Box 2536 INS URER{SI AFFORDING COVERAGE NAIC 0 <br /> Chapel Hill NC 27515-2536 INSURER A: Acadia Insurance Company 31325 <br /> INSURED INSURER B: Bridgeffeld Casualty 10335 <br /> Warren-Hay Mechanical Contractors Inc INSURER C: <br /> Sheet Metal Duct Suppliers LLC INSURER D: <br /> PO Box 818 INSURER E: <br /> Hillsborough NO 27278 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: CL1 81 22824 327 REVISION NUMBER- <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS ARID CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER M POLICY MIDDIYYYY MMIDDIYYYY LIMITS <br /> x COMMERCIAL GENERAL LIABILITY 1,000.000 <br /> EACH OCCURRENCE S <br /> CLAIMS-MADE �OCCUR PREMISES Ea occurrence S 100,000 <br /> MED EXP(Any one person) S 10.000 <br /> A CPA4429328 12/31/2018 12J3112019 PERSONAL&AUV INJURY s 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000.000 <br /> �JC POLICY Eg JE a LOC PRODUCTS-COMP/OP AGG S 2,000,000 <br /> OTHER: $ <br /> I L <br /> AUTOMOBILE LIAB B NED N E LIMITILITY Ea accident) $ 1,000,000 <br /> x ANY AUTO BODILY INJURY(Per person) S <br /> A OWNED SCHEDULED CPA4429328 12J3112018 12/31/2019 BODILY INJURY IPeracddent) S <br /> AUTOS ONLY AUTOS <br /> x HIRED IX NON-OWNED <br /> PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Par aaideM <br /> Endorsements $ <br /> X UMBRELLA LIAR X OCCUR EACH OCCURRENCE s 3,000,0DD <br /> A EXCESS LIAS CLAIMS-MADE CPA4429328 12/31/2018 12131/2019 AGGREGATE S 3,000,000 <br /> ❑ED F I RETENTIONS I $ <br /> WORKERS COMPENSATION x PER .x OTH- <br /> AND EMPLOYERS'LIA81LITV YIN STATUTE ER <br /> 500.000 <br /> B ANY CERIMEETORIPARTN0EDXECUTIVE NIA 0198-40173 12/3112018 12131J2019 E.L EACH ACCIDENT S <br /> OFF ICERIMEMBER ExGLU0E0? <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE s 500.000 <br /> It yes,describe under 500.000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> LeasedlRented Equipment LIMIT $50,000 <br /> A Installation Floater CPA4429328 12/31/2018 12131/2019 LIMIT $500,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES;ACCRD 101,Additional Remarks Schedule,may be attached If more space is requ Ire dl <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27276 <br /> �c7 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />