Orange County NC Website
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />INSURER(S) AFFORDING COVERAGE <br />INSURER F : <br />INSURER E : <br />INSURER D : <br />INSURER C : <br />INSURER B : <br />INSURER A : <br />NAIC # <br />NAME:CONTACT <br />(A/C, No):FAX <br />E-MAILADDRESS: <br />PRODUCER <br />(A/C, No, Ext):PHONE <br />INSURED <br />REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES <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 lieu of such endorsement(s). <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 />OTHER: <br />(Per accident) <br />(Ea accident) <br />$ <br />$ <br />N / A <br />SUBR <br />WVD <br />ADDL <br />INSD <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 AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />$ <br />$ <br />$ <br />$PROPERTY DAMAGE <br />BODILY INJURY (Per accident) <br />BODILY INJURY (Per person) <br />COMBINED SINGLE LIMIT <br />AUTOS ONLY <br />AUTOSAUTOS ONLY NON-OWNED <br />SCHEDULEDOWNED <br />ANY AUTO <br />AUTOMOBILE LIABILITY <br />Y / N <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />DESCRIPTION OF OPERATIONS below <br />If yes, describe under <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />$ <br />$ <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. EACH ACCIDENT <br />EROTH-STATUTEPER <br />LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />EXCESS LIAB <br />UMBRELLA LIAB $EACH OCCURRENCE <br />$AGGREGATE <br />$ <br />OCCUR <br />CLAIMS-MADE <br />DED RETENTION $ <br />$PRODUCTS - COMP/OP AGG <br />$GENERAL AGGREGATE <br />$PERSONAL & ADV INJURY <br />$MED EXP (Any one person) <br />$EACH OCCURRENCE <br />DAMAGE TO RENTED $PREMISES (Ea occurrence) <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO-JECT LOC <br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />CANCELLATION <br />AUTHORIZED REPRESENTATIVE <br />ACORD 25 (2016/03) <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />CERTIFICATE HOLDER <br />The ACORD name and logo are registered marks of ACORD <br />HIRED <br />AUTOS ONLY <br />6/13/2021 <br />Scott Insurance <br />400 Bellemeade Street,Suite 201 <br />Greensboro NC 27401 <br />336-273-6599 336-273-5915 <br />Zurich American Insurance Company (A+)16535 <br />SHAMENV-03 Evanston Insurance Company (A)35378ShamrockEnvironmentalCorporation;COP Shamrock Holdings,Inc. <br />COP Shamrock Parent,Inc.;Shamrock Environmental Construction, <br />Inc. <br />6106 Corporate Park Drive <br />Browns Summit NC 27214 <br />Navigators Specialty Insurance Company (A+)36056 <br />1155879840 <br />A 2,000,000 <br />X 300,000 <br />10,000 <br />X X.C.U.2,000,000 <br />4,000,000 <br />X <br />GLO 3433314 10/1/2020 10/1/2021 <br />4,000,000 <br />A 2,000,000 <br />X <br />X X <br />X Comp $500 X Coll:$1,000 <br />BAP 3433313 10/1/2020 10/1/2021 <br />B <br />C X 5,000,000 <br />X <br />MKLV2EFX100569 <br />GA20EXCZ02LTYIC <br />10/1/2020 <br />10/1/2020 <br />10/1/2021 <br />10/1/2021 5,000,000 <br />X 0 Excess over Umbrella 3,000,000 <br />A XWC343331210/1/2020 10/1/2021 <br />1,000,000 <br />1,000,000 <br />1,000,000 <br />B <br />A <br />Contractor Pollution/Professional <br />Installation Floater MKLV2ENV101881 <br />CPP015825804 <br />10/1/2020 <br />10/1/2020 <br />10/1/2021 <br />10/1/2021 <br />10,000,000 per occur <br />1,000,000 <br />10,000,000 per agg <br />Re.Project:Eubanks Road C&D Landfill Phase 2 Construction <br />Orange County Solid Waste is additional insured as respects general liability,auto liability,and pollution liability,and umbrella liability,on a primary and <br />non-contributory basis and including products and completed operations,if required by written contract.A waiver of subrogation as respects workers <br />compensation,general liability,auto liability,and umbrella liability applies in favor of Orange County Solid Waste if required by written contract.A 30 day notice <br />of cancellation will be provided to the certificate holder except for nonpayment of premium. <br />Orange County Solid Waste <br />Eubanks Road C&D Landfill <br />1514 Eubanks Road <br />Chapel Hill NC 27516 <br />DocuSign Envelope ID: 0844D1D6-E311-4FC5-8B5B-BB1E27A908ED