2020-232-E Solid Waste - Hammerstruck breakroom repair

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DocuSign Envelope ID:5C96407F-01 C8-436B-9803-438A891 DFC99 HAMME-2 OP ID: CR FA -1 I"7�QR0` DATE(MWDWYYYY) CERTIFICATE OF LIABILITY INSURANCE 03/04/2020 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: Christopher Ives Rubish High&Rubish Insurance Agency PHONE FAX P.O.Box 3040 A/c No Ext:919-913-1144 A/C,No): 919-913-1155 6015 Farrington Rd.Ste 101 E-MAIL Chrisr hi handrubish.com Chapel Hill,NC 27517 ADDRESS: g Christopher Ives Rubish INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Erie Insurance INSURED HammerStruck LLC INSURER B: 5100 Paschall Dr Durham, NC 27705 INSURERC: INSURER D: 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 TYPE OF INSURANCE DDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 DAMAGE TO CLAIMS-MADE ❑X OCCUR Q34 0421315 10/04/2019 10/04/2020 RENTS 2,000,00 PREMISES Ea occurrence $ MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,00 POLICY F7 PRO- JECT ❑ LOC PRODUCTS-COMP/OP AGG $ 4,000,00 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident A ANY AUTO Q34 0421315 10/04/2019 10/04/2020 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS �( �( NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DIED RETENTION$ $ WORKERS COMPENSATION x( PER OTH- AND EMPLOYERS'LIABILITY STATUTE I I ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N Q94 0400757 10/04/2018 10/04/2019 E.L.EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? ❑N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,00 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Rented Equipment Q34 0421315 10/04/2019 10/04/2020 Equipment 250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ORCOU-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Planning & THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g y g ACCORDANCE WITH THE POLICY PROVISIONS. Inspections 306 Revere Road Hillsborough, INC 27278 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD