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<br />'J <br />') <br />'J <br />) <br />) <br />~) <br />) <br />') <br />) <br />) <br />) <br />) <br />") <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />. ) <br />) <br />) <br />) <br />) <br />) <br />) <br /> <br />~ <br /> <br />CREAT-3 <br /> <br />OP 10: AW <br /> <br />~'fD-:;t.''''''''~ERJIFICATE OF LIABILITY INSURANCE I DATE (MM/DO/YVYYI <br />11/17/11 <br />THIS CERTIFICATE IS' ISSUED ASA 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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificete holder in lieu of such endorsement(~l. <br />PRODUCER 770-381-5000 ~~~~CT Ashley Williams <br />L1~d Pro Group Inc. - Duluth ~jkE.tl: ---- ----Tfl,[NO}: 770-814-7187 <br />26 5 Brecklnridge Blv, Ste 100 <br />Duluth, GA 30096 Jt'DA~~SS: awllllams@/Ioydprogroup.com <br />Jennifer Straughter - ~_._--_._- <br /> INSURER(S) AFFORDING COVERAGE NAIC ~ <br /> - INSURER A: Accident Insurance Co - ----------- - -. <br />INSURED Creative Impressions INSURER II : National Fire Ins of Hartford 524126 <br /> 4708 S. Old Peachtree Rd 5008 INSURER C : CONTINENTAL CASUALTY COM P ANY <br /> Norcross, GA 30071 <br /> INSURER D : --- <br /> INSURER E : I <br /> , ... .-,- <br /> INSURER F : i <br /> <br />COVERAGES <br /> <br />CERTIFICATE NUMBER: <br /> <br />REVISION NUMBER: <br /> <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br />) <br /> <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 PAlD CLAIMS. <br />IN~~ ' ~DDl ,"UBI< 'rpI'i[jI"y EFF ~m-~?Y EXP liMITS <br />l'lTR TYPE OF INSURANCE '~"D r..;.~,:.. POLICY NUMBER M iiNYVvl <br /> GENERAL liABiliTY I EACH OCCURRENCE S 1,000,000 <br /> - <br />8 .-!... :3'MERCIIU. GENERAl LIABILITY X B4018250912 I 05121111 05121112 ~~S E8 occurrence' S 300,000 <br /> CLAIMS-MADE 00 OCCUR --.----- 10,000 <br /> - I MED EXP (Any 0"" person) S <br /> ___u 1,000,000 <br /> PERSONA1. a AnV INJURY S <br /> - 2,000,000 <br /> f-- I GENERAL AGGREGATE S <br /> nl A~Em LIMIT APnS PER: I PRODUCTS - COMP/OP AGG S ___2~000,O~_~ <br /> POLICY X ~,9,: lOC I S <br /> I <br /> AUTOMOBILE liABilITY i I ~OMBlNED SINGLE LIMIT 5 1,OOO,OO( <br /> - Ea accldenl <br />8 ANY AUTO I B4018250912 05121111 05121112 BOOllY INJURY (Per person) S <br /> - IU.l OWNEO - SCHEOULED - <br /> AUTOS AUTOS BOOll Y INJURY (Per accidenl) S <br /> - - NQN.OWNED ip~=~GE -------------- <br /> ..!. HIRED AUTOS ..!. AUTOS S <br /> S <br /> ~ UMBRellA lIAB ~ OCCUR EACH OCCURRENCE Is 3,OOO,OO~ <br />C EXCESS llAB CLAIMS-MADE B4018250960 05121111 05121112 AGGREGATE s 3.000,OOC <br /> CEO I X I RETENTIONS ---_.- <br /> 10,000 S <br /> WORKERS COMPENSATION X IT~~Tl"uT}4" I PJH- <br /> AND EMPLOYERS' liABILITY ER <br /> Y/N WCV6066039 500,000 <br />A IWY PROPRIETORlPARTNERlEXECUTIVE 0 05121111 05121112 E.L EACH ACCIDENT S <br /> OFFICERlMEMIlER EXCLUDED? N/A 500,000 <br /> (Mandatory In NH) E.l. DISEASE - EA ElAPLOYEE S -- -- <br /> ~rssc:~~ 'b~PERATIONS below E.L DISEASE - POLICY liMIT $ 500,000 <br />8 B4018250912 05121111 05121112 PROPERTY 128,00( <br />'DESCRIPTlON OF OPERATIONS flOCATIONS f VEHICLES ~lllChACORD 101, Addlllonal Romarl<. SchlOdul.. If mOlO lpace II requlrod) <br />Re: prodect:Trident Medical Center at 9330 edlcal Plaza Drive, CharlestOn <br />SC 294 6 <br />The Certificate Holder, project owner, architect and en9ineers, Including <br />their officers, arents, and employees are named Additional Insureds, as per <br />written contrac . <br /> <br />j-) <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br />, ~cL.W~ <br /> <br />ACORD 25 (2010/05) <br /> <br />@ 1988-2010 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />