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<br />. <br /> <br />. I CERTIFICATE OF INSURANCE ISSUE DATE <br /> ACORD,.. 02109/2009 <br />. PRODUCER This certificate is issued as a matter of information only and confers no rights <br />. MCGRIFF, SEIBELS & WILLIAMS OF GEORGIA, INC. upon the Certificate Holder. This Certificate does not amend, extend or alter the <br /> 5605 Glenridge Drive - Suite 300 coverage afforded by the policies below. <br />. Atlanta, GA 30342 COMPANIES AFFORDING COVERAGE <br /> 404 497-7500 <br />. Company <br />. A Illinois Union Insurance Co <br />. INSURED Company Old Republic Insurance Co <br /> Hybrid Concrete Structures B <br />. 685 Red Oak <br />. Stockbridge, GA 30281 Company American International South Ins. <br /> C <br />~ Company <br /> 0 <br />~ Company <br />~ E <br />C This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding <br />any requirement, term or condition of contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by <br />C the policies described herein is subject to all the terms, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims. <br />r CO TYPE OF INSURANCE POLICY NUMBER EFFECTIVE LIMITS OF LIABILITY <br />LT EXPIRATION <br />C A GENERAL LIABILITY G2405228A001 01/01/2009 EACH OCCURRENCE $ 1,000,000 <br /> IX! Commercial General liability 01/01/2010 FIRE DAMAGE $ 100,000 <br />C o Claims Made IXI Occurrence MEDICAL EXPENSE $ 5,000 <br /> o Owners' and Contractors' Protection PERS. AND ADVERTISING INJURY $ 1,000,000 <br />C 0 <br /> 0 GENERAL AGGREGATE $ 2,000,000 <br />C General Aggregate Limit applies per: PRODUCTS AND COMPo OPER. AGG. $ 2,000,000 <br /> o Polley IX] Project 0 location <br />Cf B AUTOMOBILE L1AI3IL1TY A2CA36060904 01/01/2009 COMBINED SINGLE LIMIT $ 1,000,000 <br />IX! Any Automobile 01/01/2010 BODILY INJURY (Per oerson) $ <br />(> o All Owned Automobiles BODILY INJURY (Peraccidentl $ <br /> o Scheduled Automobiles <br />d IX! Hired Automobiles PROPERTY DAMAGE (Per accidentl $ <br /> IX! Non-owned Automobiles COMPREHENSIVE <br />(~ 0 COLLISION <br />(~ WORKERS' COMPENSATION We: imlt I I Other I I <br /> AND EMPLOYERS' LIABILITY EL EACH ACCIDENT $ <br />(') '1=1 DI!':I=ASE lEach emnlnvep.\ $ <br /> EL DI~EASE IPolicv Limit) $ <br />OC EXCESS LIABILITY BE6564757 01/01/2009 EACH OCCURRENCE $ 2,000,000 <br />IX! Occurrence DClalms Made 01/01/2010 AGGREGATE $ 2,000,000 <br />C~ Relentlon/Deductible 10,000 <br />I $ <br />() $ <br /><) $ <br /> $ <br />~edUCtible: $1,000 Comprehensive/Collision $ <br />. <br />. <br />QERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />. THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO <br />. MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br /> LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF <br />. ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br />. Authorized Representative <br />. Hybrid Concrete Structures ~~ <br /> 685 Red Oak Road <br />.Stockbridge, GA 30281 <br />n <br /> paae 1 of 1 CertifICate 10 # 1JNEJEKU <br /> <br />II <br />Ii <br />I <br /> <br />I <br />[I <br />Iii <br /> <br />I. <br />!n <br />