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ACDRD„ CERTIFICATE OF LIABILITY INSURANCEPENDE <br />DA12 <br />1 <br />-ID V 2 <br />12/0 <br />/0DD/2/9 <br />99 <br />PRODUCER <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />First Insurance Services, Inc. <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. TH;S CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. 0. Sox 13687 <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />RTP NC 27709 <br />01/01/00 <br />Phone:919 -941 -0549 Fax:919 -941 -0135 <br />INSURERS AFFORDING COVERAGE <br />INSURED <br />INSURER A: Penn. Natl. Mutual Cas. Co. <br />INSURERS: Key Risk Insurance Company <br />$ 5,000. <br />INSURER C: <br />Pendergraph Electric Inc. <br />P O Box 11458 <br />Durham NC 27703 <br />INSURER D: <br />INSURER E: <br />GENERAL AGGREGATE <br />COVERAGES <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR <br />TYPE OF INSURANCE <br />POLICY NUMBER <br />DATE MM /DD/YY <br />POLICY AE MM /DD/YY <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE ® OCCUR <br />AC 9 0 0 4 2 8 2 9 <br />01/01/99 <br />01/01/00 <br />EACH OCCURRENCE <br />$ 1,000,000. <br />FIRE DAMAGE (Any one fire) <br />$ 100,000. <br />MED EXP (Any one person) <br />$ 5,000. <br />PERSONAL & ADV INJURY <br />$ 1,000,000. <br />GENERAL AGGREGATE <br />$ 2,000,000. <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO- <br />JECT LOC <br />PRODUCTS - COMP /OP AGG <br />$ 2r0001000. <br />A <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED AUTOS <br />SCHEDULED AUTOS <br />HIRED AUTOS <br />NON -OWNED AUTOS <br />AU90042829 <br />01/01/99 <br />01/01/00 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 500,000. <br />X <br />BODILY INJURY <br />(Per person) <br />$ <br />X <br />BODILY INJURY <br />(Per accident) <br />$ <br />X <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />GARAGE LIABILITY <br />R ANY AUTO <br />AUTO ONLY - EA ACCIDENT <br />$ <br />OTHER THAN EA ACC <br />AUTO ONLY: AGG <br />_XXX <br />$ XXX <br />_ <br />$ XXX <br />A <br />EXCESS LIABILITY <br />X OCCUR 7 CLAIMS MADE <br />DEDUCTIBLE <br />X RETENTION $ 10,000 <br />UL90042829 <br />01101199 <br />01/01/00 <br />EACH OCCURRENCE <br />$2,000,000. <br />AGGREGATE <br />$2,000,000. <br />$ <br />$ <br />B <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br />900000000139099 <br />07/01/99 <br />07/01/00 <br />X I TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />_ <br />$100,000. <br />E.L. DISEASE - EA EMPLOYEE <br />$ 100,000. <br />E.L. DISEASE - POLICY LIMIT <br />$500,000, <br />OTHER <br />DESCRIPTION OF OPERATIONS /LOCATIONSA%EHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br />Project: Stanby Generator fit -up for Stanford Middle School, Hillsborough NC <br />The owner (County of Orange Dept of Purchasing & Central Services) & Orange County Schools & <br />Designer (Sunderland Engineering, Inc.) are named as Additional Insureds <br />with respects to the General Liability. Attached is the Cancellation Clause <br />& the letter dated 11 -15 -99 <br />•-• •�• • ••+ j I ui IIVIYI1L 1iVJVRCVIIVJVRCR LCIICR; V/'11VVGLL/111VIV <br />COUNTY3 <br />County of Orange Department X3�XXXXiXii3GXI0�X)iX��CiXX <br />of Purchasing & Central j�{}X�;yXXXXXX>Xi}boyn}�XX <br />Services X>XisXXrIiXX�iXX§�§�i}XXIXX <br />132 E. King Steet <br />Hillsborough NC 27278 Xe7fXi�X XX1XXtXXXXXXX <br />ACORD 25 -S (7/97) <br />a ropkN <br />