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2023-613-E-DEAPR Dept-Seamless Gutter Systems-Gutter Replacement
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2023-613-E-DEAPR Dept-Seamless Gutter Systems-Gutter Replacement
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Last modified
11/21/2023 9:46:32 AM
Creation date
11/21/2023 9:46:24 AM
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Contract
Date
10/19/2023
Contract Starting Date
10/19/2023
Contract Ending Date
10/26/2023
Contract Document Type
Contract
Amount
$5,340.60
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />INSURER(S) AFFORDING COVERAGE <br />INSURER F : <br />INSURER E : <br />INSURER D : <br />INSURER C : <br />INSURER B : <br />INSURER A : <br />NAIC # <br />NAME:CONTACT <br />(A/C, No):FAX <br />E-MAILADDRESS: <br />PRODUCER <br />(A/C, No, Ext):PHONE <br />INSURED <br />REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES <br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />(Per accident) <br />(Ea accident) <br />$ <br />$ <br />N / A <br />SUBR <br />WVD <br />ADDL <br />INSR <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 />$PROPERTY DAMAGE <br />BODILY INJURY (Per accident) <br />BODILY INJURY (Per person) <br />COMBINED SINGLE LIMIT <br />AUTOS <br />AUTOSAUTOSNON-OWNEDHIRED AUTOS <br />SCHEDULEDALL OWNED <br />ANY AUTO <br />AUTOMOBILE LIABILITY <br />Y / N <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />DESCRIPTION OF OPERATIONS below <br />If yes, describe under <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />$ <br />$ <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. EACH ACCIDENT <br />EROTH-TORY LIMITSWC STATU- <br />LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, 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 />GENERAL LIABILITY <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 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. <br />CERTIFICATE HOLDER <br />The ACORD name and logo are registered marks of ACORD <br />10/17/2023 <br />The Ballard Agency <br />105 W King St. <br />Hillsborough NC 27278 <br />Lee Hammond <br />919-732-2158 <br />lee@ballardagencyinc.com <br />Seamless Gutter Systems Inc <br />6720 Pentecost Rd <br />Cedar Grove NC 27231-9269 <br />Erie Insurance Exchange 26271 <br />Security National Insurance Company 19879 <br />A Q280520415 04/05/2023 04/05/2024 <br />1,000,000 <br />1,000,000 <br />5,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />A Q052130835 05/21/2023 05/21/2024 <br />1,000,000 <br />B Y SWC1419401 11/25/2022 11/25/2023 <br />100,000 <br />500,000 <br />100,000 <br />Orange County is an additional insured as respects general liability arising from the insured's operations when required by written contract, per Blanket <br />Additional Insured form ULRH. <br />Orange County <br />PO Box 8181 <br />Hillsborough NC 27278 <br />DocuSign Envelope ID: 09614F91-7907-4F81-969F-F9E9BD0ACEF8
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