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HomeMy WebLinkAbout2014-506 Solid Waste - Purpose Recycling for recycling $14,000 Sbl A1�as ORANGE COUNTY ASSIGNMENT OF CONTRACT NORTH CAROLINA Mattress Go Round entered into an agreement on June 18, 2013 with Orange County,North Carolina to provide mattress/box spring collection and recycling services. By mutual agreement of the parties, all rights, obligations and responsibilities of Mattress Go Round under this agreement are assigned to Purpose Recycling, effective as of August , 2014. All terms and conditions of the original agreement now apply to the Assigned Agreement between Orange County and Purpose Recycling. By: _ Printed Name: Title: coon`:'% Orangq County,North Carolina By: f Printed Name: q U Title: Mattress, o Round B : Y 1 Printe"me: Title: T>•(� ,.. Purpose Recycling "_"I MATTRA OP ID:CL A1COR° CERTIFICATE OF LIABILITY INSURANCE DATE 08/2 512 0 1 YY) 08/2512014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAMEA T Christina H. Lail ISU/Twin City Insurance Agency PHONE g28 464-2643 FAC No): 828-466-0605 P 87 AIC No Ext. A! , O. Box 1 29 South College Avenue ADDRESS.christy@twinciVinsurance.net Newton, NC 28658 Harry L.Hight,CIC,CLU INSURER($)AFFORDING COVERAGE NAIC>R INSURERA.First Benefits Insurance Co. 13098 INSURED Mattress Go Round, LLC INSURER Peerless Insurance Company Purpose Recycling, LLC INSURERC Erie Insurance Exchange 26271 ATTN: Robert Savino 1601-A Yanceyville Street INSURER Great Lakes Reinsurance Greensboro, NC 27405 INSURERE INSURER F. COVERAGES CERTIFICATE NUMBER: 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 POLICY NUMBER MMIDD E LTR MWDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL.LIABILITY X GL8912229 06/08/2014 06/08/2015 PREMISES(Ea occ ence) $ 500,00 CLAIMS-MADE I I OCCUR MED EX.P(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 (Ea accident) $ C X ANY AUTO X Q052030819 05/2012014 0512012015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OVYNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS PER ACCIDENT UM/UIM $ 1,000,00 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ WORKERS COMPENSATION X STATUS O R AND EMPLOYERS'LIABILITY TOORR Y LIMITS ER Y!N A ANY PROPRIETORIPARTNERfEXECLITIVE WC63842014 05/20/2014 05/20/2015 EL EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? F NIA (Mandatory In NH) E L DISEASE-EA EMPLOYEE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E1 DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Solid Waste ACCORDANCE WITH THE POLICY PROVISIONS. Management PO Box 17177 AUTHORIZED REPRESENTATIVE Chapel Hill, NC 27516 �JI16�t�GL4� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD