3.8.23 PB Agenda Packet - Laserfiche WebLink

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999 AC40 CERTIFICATE OF LIABILITY INSURANCE DATE7/27/2022 V) 111 07/27/2022 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 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 certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: N.C. Farm Bureau Ins.Agency PHONE FAX (AK:.No.Extl: (A/C,No): I 5301 Glenwood Avenue (27612) E-MAIL I ADDRESS: P.O.BOX 27427 INSURER(S)AFFORDING COVERAGE NAIC N I Raleigh NC 27611 INSURERA: Capitol Specialty Insurance Corporation I INSURED I INSURER B Ronald H.Pittman,II DBA INSURERC: I Pittman Soil Consulting INSURER D: I 1003 Gregory Fork Rd INSURER E: I Richlands NC 28574 INSURERF: COVERAGES CERTIFICATE NUMBER: CL2272123407 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 3 SUER LIMITS LTR TYPE OF INSURANCE INSo WVD POLICY NUMBER (MMIDD/YYYN1 MMIDD/YYWI COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR PREMISES(Ea occurrence $ 50,000 MED EXP(Any one person) $ 5,000 I A X Professional Liability EV20182381-05 07/19/2022 07/19/2023 PERSONAL&ADV INJURY $ 1,000,000 I LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 I POLICY JECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER ProfessionalOcc/Agg $ 1M/2M I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ _ (Ea accidenU ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED HNON-OWNED PROPERTY DAMAGE $ ' AUTOS ONLY AUTOS ONLY (Per accident $ ' UMBRELLA LIAB OCCUR EACH OCCURRENCE $ I EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DIED I I RETENTION$ $ I WORKERS COMPENSATION I STATUTE I I EORH AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E. I OFFICER/MEMBER EXCLUDED? NIA .L.EACH ACCIDENT $(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ I If yes,desaibe under I DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Contractors Pollution Liability- Each Incident $1,000,000 A Occurence Form EV20182381-05 07/19/2022 07/19/2023 Aggregate Limit $2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTA NC 28540 01 2015 A O ORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registe marks - A D