2021-156-E DEAPR-RES Carolinas LLC driveway pipe replacement

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DocuSign Envelope ID:3E38OE16-OEE4-4809-9C60-91EC84F8B4C8 DATE(MMIDD/YYYY) .a►to►,�r� CERTIFICATE OF LIABILITY INSURANCE 02/25/2021 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 w certificate does not confer rights to the certificate holder in lieu of such endorsement(s). u PRODUCER CONTACT 9 AOn Risk Insurance Services West, Inc, NAME: Denver CO Office acNri.E■u: (303) 758-7668 ac Nol: (303) 758-9a58 32 1900 16th Street, Suite 1000 E-MAIL 2 Denver CO 80202 USA ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC N INSURED INSURERA: Scottsdale Ins Company 41297 RES Carolinas, LLC INSURER B: Zurich American Ins Co 16535 DBA Carolina Environmental Contracting PQ BOX 1905 INSURER C: Mount Airy NC 27030 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570086143632 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 Limits shown are as requested INSR ADDL SUER POLICY NUMBER POLICY EFF POLICY E%P LIMITS IMM/OnMIVVI .To Aw TYPE OF INSURANCE X COMMERCIAL GENERALLIABILITY n VR50 4 1 7 1 wt EACH OCCURRENCE $1,000,000 CLAIMS-MADE I X OCCUR DAMAGE TO RENTED $350,000 LL rPLRERLSES IEa _ MED EXP(Any one person) S10,000 PERSONAL&ADV INJURY $1,000,00 tv GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000,00 POLICY ❑X ECT p LOC PRODUCTS-COMP/OPAGG $2,000,000 m OTHER O O r B AUTOMOBILE LIABILITY BAP 8633906-00 02/01/2021 10/01/2021 COMBINED SINGLE LIMIT $1,000,000 !Fa amidentl X ANY AUTO BODILY INJURY(Per person) O OWNED SCHEDULED BODILY INJURY(Per accident) Z AUTOS ONLY AUTOS N HIRED AUTOS NON-OWNED PROPERTY DAMAGE V ONLY AUTOS ONLY IPeraccident) 1r N 'AJiS.UMBRELLA LIAB X OCCUR VE50003252 12/31/2020 10/01/2021 EACH OCCURRENCE S5,000,000 L) LIABCLAIMS-MADE occurrence Ba515AGGREGATE $S,000,OOO RETENTION B WORKERS COMPENSATION AND WC863390700 02/01/2021 10/01/2021 X I PER STATUTE OTH EMPLOYERS'LIABILITY YIH ANY PROPRIETOR I PARTNER I E%ECUTIVE E L EACH ACCIDENT $1,000,000 OFFICER] EMBER EXCLUDED? N NIA (Mandatory in NH) E L DISEASE-EA EMPLOYEE $1,000,000 I(yes,describe under nFSCRIPTION OF OPFRATION$tnlfwy E L DISEASE-POLICY LIMIT $1.000.000 J_ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) J Re: Bid No. 367-005306: orange County Twin Creeks Park Driveway Culvert Replacement Project. Evidence of insurance •c CERTIFICATE HOLDER CANCELLATION -4+ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE Sri POLICY PROVISIONS Orange County AUTHORIZED REPRESENTATIVE PO Box 8181, 405 Meadowlands drive, Hillsborough NC 27278 USAs7�/� � n n,�utu�rex cfit�iezd eta ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25[2016103) The ACORD name and logo are registered marks of ACORD