2020-113-E OCTS - Tommy Lawrence Electric Company wiring

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DocuSign Envelope ID:ADB9254F-28AD-4510-8F1A-A9C46E8FC439 LAWRE-1 OP ID: BP ACdRO 701/1712020`� ATE[MM10DlYYYY) CERTIFICATE OF LIABILITY INSURANCE 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 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: Phillip Allen Thompson-Allen,Inc. PHONE FAX P.O.Box 100 Arc No Exe:336-599-2175 arc No: 336-599-6932 Roxboro,NC 27573 E-MAIL Barbara Piper INSURERS AFFORDING COVERAGE NAIC p INSURER A;Cincinnati Insurance Company 10677 INSURED Tommy Lawrence Electrical INSURER B.Cincinnati Casualty Company 28665 Contractor's Inc. P.Q. Box 641 INSURER C Roxboro, NC 27573 INSURERD: INSURER E: INSURER F: COVERAGES 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 1 ADDL SUB POLICY EFF POLICY EXP LTR I TYPE OF INSURANCE I INSD WVD POLICY NUMBER 4MWDDJYYYYI (MWDDNM) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 CLAIMS-MADE FRI OCCUR X EPP 0096783 01101/2020 011011202, DAMAGE TO RENTED ��Q oo� PREMISES Ea occurrence $ r MEO EXP(Any one person) $ 10,00 PERSONAL&ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY X JEST F7 LOG PRODUCTS-COMPIOP AGG $ 2,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea $ 11000,000 accident A X ANY AUTO �EBA 0096783 01101/2020 01/0112021 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOAUTOS S X NON-OWNED PROPERTY DAMAGE $ X HIRED AUTOS AUTOS NU Par accident AUTOS ED X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 A EXCESS LIAB CLAIMS-MADE EPP 0096783 0110112020 01/01/2021 AGGREGATE $ 5,000,000 DIED I I RETENTION$ $ WORKERS COMPENSATION X IPER STATUTE ER H AND EMPLOYERS'LIABILITY B ANY PROPRIETORIPARTNERIEXECUTiVE YINNIA EWC 0368238-02 01/0112020 01101/2021 E.L.EACH ACCIDENT $ 100,00 OFFICERIMEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATICNS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Orange County is named as additional insured. CERTIFICATE HOLDER CANCELLATION ORANGEC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g ty ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE Barbara Piper , �:�,Apla,,D4u,-, ©1988-2014 ACORD CORPO ATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD