The URL can be used to link to this page

Home My WebLink AboutTHE POTTS CERTIFICATE OF LIABILITY INSURANCE JUDICIAL CENTER FEfjD 4 2010 Client#: 1062358 126POTTSCO ACORDTM CERTIFICATE OF LIABILITY INSURANCE DAlE (MMIDDIYYYY) 01/15/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER BB&T Insurance - Conyers 3205 Salem Road Suite A Conyers, GA 30013 INSURED INSURERS AFFORDING COVERAGE INSURER A: Cincinnati Insurance Compan INSURER B: Builders Insurance (A Mutual Ca INSURER C: INSURER D: INSURER E: NAIC# 10677 10704 The Potts Co. Potts General Contractors and Mike Potts 981 E. Freeway Dr. Conyers, GA 30094 COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ITD I....D. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A ~NERAL UABILlTY CPP1055449 02101/2010 02/01/2011 EACH OCCURRENCE $1 000 000 x. SMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100000 - CLAIMS MADE [Xl OCCUR MED EXP (Anyone person) $5 000 X PD Ded:500 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE $2 000 000 ~'L AGG~EnE LIMIT APPlS PER: PRODUCTS - COMP/OP AGG $2 000 000 POLICY ':'f,9;: LOC A ~TOMOBILE LIABILITY CPA1055449 02101/2010 02/01/2011 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1,000,000 - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - X HIRED AUTOS BODILY INJURY $ .!. NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) ~GE LIABILITY AUTO ONLY- EA ACClDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ A ::i]ESS I UMBRELLA LIABILITY CPP0742949 02/01/2010 02/01/2011 EACH OCCURRENCE $10 000 000 X OCCUR D CLAIMS MADE AGGREGATE $10 000 000 $ R DEDUCTIBLE $ RETENTION $ $ B WORl<ERS COMPENSATION AND WCV001822306 02101/2010 02/01/2011 X I WCSTATU- I IOJ~ EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ~ E.L. EACH ACCIDENT $100.000 l1I:~~r~R~r EXCLUDED? N E.L. DISEASE - EA EMPLOYEE $100000 ~~I~~R~~~18'NS below E.L. DISEASE - POLICY LIMIT $500.000 A OTHER Builders Ris CAP5858254 12/31/2009 12/31/2010 48,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Workers Compensation is for Georgia only and provides GA benefits only Augusta Richmond County, as "owner" and it's officers, members and employees are additional insured with respects to general liability if required by written contract. CERTIFICATE HOLDER Augusta Richmond County 530 Green St Room 801 Augusta, GA 30911 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DAlE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL --10- DAYS WRITTEN NOTICE TO THE CERTlFlCAlE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRE~NTAI!YE ~.'" .~ O"'~.;. #S4562848/M4562837 @ 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MBD ACORD 25 (2009/01) 1 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2009/01) 2 012 #S4562848/M4562837 Augusta-Richmond County Capital Improvements Program Management 501 Greene Street, Suite 313, Augusta, Georgia 30901 Transmittal Phone: ( 706) 842-5559 Fax: (706)821-2484 To: Ms. Lena Bonner From: M. Lindsav Johnson Comoanv: ARC Clerk, Commission Date: Februarv 5, 2010 Address: 530 Greene Street, 8th Floor Re: Judicial Center - Potts CM Ciil Risk City-County Bldg. Liabilitv Insurance update Augusta, GA 30911 Phone No: Proiect: Judicial Center Fax No: WF"B ""m~ht '" Barn. Bprn. If Fax, original Uwill Uwill not follow Mail Courier by a.m. p.m. If Fax, # Daoes including this one: X Other Inter- Office mail Quantitv DescriDtion 1 Certificate of Liabilitv insurance dated 1/15/2010 notino renewal for oeriod from 2/1/2010 to 2/1/2011 on the Judicial Center Construction Droiect for the County records. I Heerv Intemational will retain a copy of the revised Liabilitv Insurance certificate in their files, also. Copied to 1".' I OS""'"," Pre ared b M. Lindsa Johnson, HEERY