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2024-098-E-AMS-F A Jenkins Construction-CO 2 Motorpool Add HVAC Work
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2024-098-E-AMS-F A Jenkins Construction-CO 2 Motorpool Add HVAC Work
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Last modified
4/8/2024 10:59:36 AM
Creation date
4/8/2024 10:59:32 AM
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Contract
Date
2/2/2024
Contract Starting Date
2/2/2024
Contract Ending Date
2/14/2024
Contract Document Type
Contract
Amount
$450.00
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EIG6230 8/11 <br />AGENT’S NO.NAME AND ADDRESS OF AGENCY <br />DATE ISSUED (MM/DD/YY) <br />NAME AND ADDRESS OF NAMED INSURED <br />This is to certify thaThis is to certify thaThis is to certify thaThis is to certify thaThis is to certify that policies,t policies,t policies,t policies,t policies, as indica as indica as indica as indica as indicated bted bted bted bted by the Policy Number belowy the Policy Number belowy the Policy Number belowy the Policy Number belowy the Policy Number below,,,,, are in f are in f are in f are in f are in force force force force force for the Named Insured aor the Named Insured aor the Named Insured aor the Named Insured aor the Named Insured at the time that the time that the time that the time that the time that the Certificat the Certificat the Certificat the Certificat the Certificate is being issued.te is being issued.te is being issued.te is being issued.te is being issued. <br />COMMERCIAL GENERAL LIABILITY <br /> CLAIMS MADE OCCUR <br /> POLICY PROJECT LOC <br />GENERAL LIABILITY <br />EXCESS LIABILITY <br />OCCURRENCE <br />RETENTION $ <br />OTHER <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />Add’lAdd’lAdd’lAdd’lAdd’l <br />Ins’dIns’dIns’dIns’dIns’d <br />POLICY EXPIRAPOLICY EXPIRAPOLICY EXPIRAPOLICY EXPIRAPOLICY EXPIRATIONTIONTIONTIONTION <br />DADADADADATE TE TE TE TE (((((MM/DD/YYMM/DD/YYMM/DD/YYMM/DD/YYMM/DD/YY)))))POLICY EFFECTIVEPOLICY EFFECTIVEPOLICY EFFECTIVEPOLICY EFFECTIVEPOLICY EFFECTIVE <br />DADADADADATE TE TE TE TE (((((MM/DD/YYMM/DD/YYMM/DD/YYMM/DD/YYMM/DD/YY)))))POLICY NUMBERPOLICY NUMBERPOLICY NUMBERPOLICY NUMBERPOLICY NUMBERTYPE OF INSURANCETYPE OF INSURANCETYPE OF INSURANCETYPE OF INSURANCETYPE OF INSURANCE <br />WORKERS COMPENSATION & <br />EMPLOYERS LIABILITY <br />AUTHORIZED REPRESENTATIVE <br />CERTIFICATE OF INSURANCE <br />— THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY — <br />EACH OCCURRENCE <br />LIMITSLIMITSLIMITSLIMITSLIMITS <br />AGGREGATE <br />__________________________ <br />__________________________ <br />GEN’L AGGREGATE LIMIT APPLIES PER: <br />$ <br />$ <br />$ <br />$ <br />AUTOMOBILE LIABILITY <br />BODILY INJURY AND <br />PROPERTY DAMAGE <br />COMBINED <br />PROPERTY DAMAGE <br />$ <br />$ <br />$BODILY INJURY <br />(EACH ACCIDENT) <br />BODILY INJURY <br />(EACH PERSON) <br />$ <br />(OWNED, HIRED, <br />NON-OWNED) <br />STATUTORY <br />BODILY <br />INJURY <br />BY <br />ACCIDENT EACH ACCIDENT <br />DISEASE POLICY LIMIT <br />DISEASE EACH EMPLOYEE <br />$ <br />$ <br />$ <br />FLAGSHIP CITY INSURANCE COMPFLAGSHIP CITY INSURANCE COMPFLAGSHIP CITY INSURANCE COMPFLAGSHIP CITY INSURANCE COMPFLAGSHIP CITY INSURANCE COMPANYANYANYANYANYCo.: GCo.: GCo.: GCo.: GCo.: G <br />Co.: DCo.: DCo.: DCo.: DCo.: D <br />ERIE INSURANCE COMPERIE INSURANCE COMPERIE INSURANCE COMPERIE INSURANCE COMPERIE INSURANCE COMPANYANYANYANYANYCo.: CCo.: CCo.: CCo.: CCo.: C <br />Co.: ECo.: ECo.: ECo.: ECo.: E <br />OWNED <br />HIRED <br />NON-OWNED <br />GARAGE <br />“ANY AUTO” <br />ERIE INSURANCE PROPERERIE INSURANCE PROPERERIE INSURANCE PROPERERIE INSURANCE PROPERERIE INSURANCE PROPERTY & CASUALTY & CASUALTY & CASUALTY & CASUALTY & CASUALTY COMPTY COMPTY COMPTY COMPTY COMPANYANYANYANYANY <br />ERIE INSURANCE COMPERIE INSURANCE COMPERIE INSURANCE COMPERIE INSURANCE COMPERIE INSURANCE COMPANY OF NEW ANY OF NEW ANY OF NEW ANY OF NEW ANY OF NEW YORKYORKYORKYORKYORKCo.: FCo.: FCo.: FCo.: FCo.: F <br />$EACH OCCURRENCE <br />$FIRE DAMAGE (Any One Fire) <br />$MED EXP (Any One Person) <br />PERSONAL & ADV. INJURY <br />GENERAL AGGREGATE <br />PRODUCTS-COMP/OP AGG <br />$ <br />$ <br />$ <br />NAME AND ADDRESS OF CERTIFICATE HOLDER <br />COCOCOCOCO <br />LLLLLTRTRTRTRTR <br />This certificate is issued for information purposes only and confers <br />no rights on the certificate holder. It does not affirmatively or <br />negatively amend, extend, or otherwise alter the terms, exclusions <br />and conditions of insurance coverage contained in the policy(ies) <br />indicated below. The terms and conditions of the policy(ies) govern <br />the insurance coverage as applied to any given situation. Limits <br />shown may have been reduced by claims paid. This certificate of <br />insurance does not constitute a contract between the issuing <br />insurer(s), authorized representative or producer and the <br />certificate holder. <br />CANCELLATION:SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIV- <br />ERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />IMPORTANT:If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the <br />terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer <br />rights to the certificate holder in lieu of such endorsement(s). <br />ERIE INSURANCE EXCHANGEERIE INSURANCE EXCHANGEERIE INSURANCE EXCHANGEERIE INSURANCE EXCHANGEERIE INSURANCE EXCHANGE <br />Erie Indemnity Co.,Erie Indemnity Co.,Erie Indemnity Co.,Erie Indemnity Co.,Erie Indemnity Co., AttorneAttorneAttorneAttorneAttorney-in-Facty-in-Facty-in-Facty-in-Facty-in-Fact <br />COMPCOMPCOMPCOMPCOMPANYANYANYANYANY(((((IESIESIESIESIES))))) AFFORDING COVERAGEAFFORDING COVERAGEAFFORDING COVERAGEAFFORDING COVERAGEAFFORDING COVERAGE <br />( )Not Not Not Not Not ApplicaApplicaApplicaApplicaApplicablebleblebleble <br />in NYin NYin NYin NYin NY <br />402 Avalon Dr <br />Mebane, NC 27302 <br /> <br />X <br />X <br />X <br />Q30 0123180 6/1/23 6/1/24 1,000,000 <br />1,000,000 <br />5,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />100,000 <br />300,000 <br />100,000 <br />2/13/242/13/23Q02 1330937 <br />X <br />X <br />100,000 <br />500,000 <br />100,000 <br />6/1/24Q90 0103892 6/1/23 <br />10/17/23 <br />JJ1628 <br />CENTRAL CAROLINA INSURANCE INC <br />F A Jenkins Construction Inc <br />Orange County <br />po box 8181 <br />Hillsborough, NC 27278 <br /> <br />2855 S CHURCH ST STE C <br />BURLINGTON, NC 27215 <br /> <br />Page 1 of 1 <br />X <br />Orange County is also listed as an Additional Insured as it relates to General Liability <br />E <br />E <br /> <br />E <br /> <br />DocuSign Envelope ID: 28A52F32-CACA-48E1-815A-E6A3C682F784
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