2024-195-E-Solid Waste-Moffat Pipe-Drainage Repairs

Browse Search

DocuSign Envelope ID:07A4359F-6D47-4987-B1F1-BF667ACBB3BA DATE(MM/DD/YYYY) ACC" CERTIFICATE OF LIABILITY INSURANCE DATE 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 A 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: Priscilla M.Bedford Jones Insurance Agency, Inc. PHONE FAX 820 Benson Road A/C No Ext: 919-772-0233 A/C No):919-779-4025 Garner NC 27529 ADDRESS: pbedford@jones-insurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:Selective Insurance Company of the Southeast 39926 INSURED MOFFPIP-01 INSURERB: Builders Premier Insurance Company 13036 Moffat Pipe, Inc.701 Finger Lakes Drive INSURERC:Travelers Property Casualty Insurance Company 36161 Wake Forest NC 27587 INSURERD: Illinois Union Insurance Company 27960 INSURER E: Great American Insurance Co. 16691 INSURER F: COVERAGES CERTIFICATE NUMBER:817894790 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY A X COMMERCIAL GENERAL LIABILITY Y Y S 2409345 3/10/2024 3/10/2025 EACH OCCURRENCE $1,000,000 TED CLAIMS-MADE � OCCUR PREMISES(Ea o DAMAGE TO ccurrence) $1,000,000 MED EXP(Any one person) $15,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 POLICY jE LOC PRODUCTS-COMP/OP AGG $3,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y Y S 2409345 3/10/2024 3/10/2025 COMBINED SINGLE LIMIT $1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident A X UMBRELLA LIAB X OCCUR Y Y S 2409345 3/10/2024 3/10/2025 EACH OCCURRENCE $5,000,000 c EX-2T734495-23-NF 3/10/2024 3/10/2025 EXCESS LIAB CLAIMS-MADE AGGREGATE $5,000,000 DED X RETENTION$n Excess Liability $10,000,000 B WORKERS COMPENSATION Y PWC 1017090 3/10/2024 3/10/2025 X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 D Pollution Liability G71790095 005 3/10/2024 3/10/2025 Pollution Liability 3,000,000 E Rented Equipment IMP F157795 2/7/2024 3/10/2025 Rented Equipment 1,500,000 A Installation Materials S 2409345 3/10/2024 3/10/2025 Installation Material 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The General Liability policy includes additional insured endorsement that provides additional insured status for ongoing operations and products and completed operations and a blanket waiver of subrogation endorsement that provides waiver of subrogation status to the certificate holder and other entities when there is a written"insured contract"between named insured and certificate holder that requires such status. •The General Liability policy contains endorsement providing primary and non-contributory status when a written"insured contract"requires such status. -The Auto Liability policy includes additional insured endorsement that provides additional insured status and blanket waiver of subrogation endorsement that provides waiver of subrogation status to the certificate holder and other entities when there is a written"insured contract"between named insured and certificate holder that requires such status. -The Auto Liability policy contains endorsement providing primary and non-contributory status when a written"insured contract"requires such status. See Attached... 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. Orange County P O Box 8181 AUT ORIZED REPRESENTATIVE Hillsborough NC 27278 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD