|
DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 10/17/2023
<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 /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pOlicy(ies) must have ADDITIONAL INSURED provisions or be endorsed . If L
<br /> SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this tE
<br /> certificate does not confer rights to the certificate holder in lieu of such endorsement(s) .
<br /> PRODUCER CONTACT
<br /> Aon Risk Insurance Services West , Inc . PHONE (303 ) 758 - 7688 FAX ( 303 ) 758 - 9458 13
<br /> Denver CO Office (A/C. No. Ext) : A/C. No.
<br /> 1900 16th Street , Suite 1000 E-MAIL s°
<br /> Denver CO 80202 USA ADDRESS:
<br /> INSURER(S) AFFORDING COVERAGE NAIC #
<br /> INSURED INSURERA: Zurich American Ins CO 16535
<br /> HGS , LLC dba RES Environmental operating INSURER B: Scottsdale Ins Company 41297
<br /> Company , LLC
<br /> 3600 Glenwood Avenue , Suite 100 INSURERC:
<br /> Raleigh NC 27612 USA INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: 570102284001 REVISION NUMBER :
<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. Limits shown are as requested
<br /> INSR ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER PP'MMlDD/YYYY MM/DD/YYYY LIMITS
<br /> B X COMMERCIAL GENERAL LIABILITY VRS0006957 10 Ol/ 2023 10/01 2024 EACH OCCURRENCE $ 1 , 000 , 000
<br /> CLAIMS-MADE I X IOCCUR DAMAGE TO RENTED $ 350 , 000
<br /> FL PREMISES Ea occurrence
<br /> MED EXP (Any one person) $ 10 , 000
<br /> PERSONAL & ADV INJURY $ 1 , 000 , 000
<br /> GEN'LAGGREGATTELI LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000 , 000 a
<br /> POLICY I I PRO LOC PRODUCTS - COMP/OP AGG $ 2 , 000 , 000
<br /> N
<br /> 1--J JECTo
<br /> OTHER: Deductible $ 25 , 000 0
<br /> ti
<br /> A AUTOMOBILE LIABILITY BAP 8633906 - 03 10/08/2023 10 /08/2024 COMBINED SINGLE LIMIT $ 2 , 000 , 000 u7
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY ( Per person)
<br /> O
<br /> OWNED SCHEDULED BODILY INJURY (Per accident) Z
<br /> AUTOS ONLY AUTOS N
<br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE
<br /> ONLY AUTOS ONLY Per accident
<br /> 'C
<br /> d
<br /> B UMBRELLA LIAB X OCCUR VES0004308 10/01/2023 10 /01/2024 EACH OCCURRENCE $ 10 , 0001000 U
<br /> X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10 , 000 , 000
<br /> X
<br /> DED I RETENTION Automobile Excess Limit $ 9 , 000 , 000
<br /> A WORKERS COMPENSATION AND WC863390703 10 /08/2023 10 /08/2024 X PER STATUTE OTH-
<br /> EMPLOYERS' LIABILITY Y / N ER
<br /> ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT $ 1 , 000 , 000
<br /> OFFICER/MEMBER EXCLUDED? N NIA
<br /> (Mandatory in NH) E. L. DISEASE-EA EMPLOYEE $ 1 , 000 , 000
<br /> If yes, describe under
<br /> DESCRIPTION OF OPERATIONS below E. L. DISEASE-POLICY LIMIT $ 1 , 000 , 000
<br /> B Environmental Contractors VRS0006957 10/01/2023 10 /01/ 2024 Ea Claim / Cvg $ 1 , 000 , 000
<br /> and Prof Prof/ Poll - claims Made Aggregate $ 2 , 000 , 000
<br /> Deductible $ 25 , 000
<br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required)
<br /> RE : RES Project No . 109816 , Project Name : Gravelly Hill Middle School Stormwater wetland Retrofit Project , Project Site
<br /> Location : NC . orange County , its officers , agents and employees are included as Additional Insured in accordance with the
<br /> policy provisions of the General Liability policy .
<br /> und
<br /> CERTIFICATE HOLDER CANCELLATION _
<br /> f�
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE F
<br /> EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE .may
<br /> POLICY PROVISIONS,
<br /> Orange County AUTHORIZED REPRESENTATIVE F�
<br /> 300 West Tryon Street i
<br /> PO Box 8181 j,7c fT
<br /> Hillsborough NC 27278 USA �p�y i �E;Q011CG' cl �tA�?JAi �Gt�il►xd ��� eJnG
<br /> efilir
<br /> ©1988 -2016 ACORD CORPORATION . All rights reserved .
<br /> ACORD 26 (2016103) The ACORD name and logo are registered marks of ACORD
<br />
|