2015-123-E Planning - Volkert, Inc. for basic services

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DocuSign Envelope ID: FC9EFE5F-2E3A-436A-9FA0-CDDB72DA1969 ,4co CERTIFICATE OF LIABILITY INSURANCE DATE '°°'YYYY' `-� 1//12/12/2015 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 CONTACT Carl Underwood NAME: Y Greyling Insurance Brokerage PHONE (770)552-4225 FAX Noiv(866)550-4082 3780 Mansell Road E-MAIL ADDRESS:Carl Y•underwood@ re lin g.com Suite 370 INSURERS AFFORDING COVERAGE NAIC q Alpharetta GA 30022 INSURERA:Zurich American Insurance Co. 16535 INSURED INSURERB:Starr Indemnity Liab. Co. 38318 Volkert, Inc. INSURERC:Catlin Insurance Company 19518 3809 Moffett Road INSURER D: P.O. BOX 7434 INSURERE: Mobile AL 36607 INSURER F: COVERAGES CERTIFICATE NUMBER:*14-15 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 ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MMIDDIYYYY) (MM/DDffYYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED MISE I, PRE S Ea occurrence $ 500,000 A CLAIMS-MADE OCCUR LO 0138380-00 11/1/2014 11/1/2015 MED EXP(Any one person) $ 15,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY X PRO-L $ AUTOMOBILE LIABILITY EOMBIINdEeD SINGLE LIMIT 1,000,000 A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AP 0138379-00 11/1/2014 11/1/2015 BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS L NON-OWNED PROPERTY DAMAGE AUTOS $ Per acc dent $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 B }[ EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED I X I RETENTION$ 0.0c 1000010744 11/1/2014 11/1/2015 $ A WORKERS COMPENSATION X I VJC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 11000,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) C 0138381-00 11/1/2014 11/1/2015 E.L.DISEASE-EA EMPLOYE $ 11000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 11000,000 C Professional Liability &ED 196314-0715 /28/2014 /28/2015 Per Claim $10,000,000 Aggregate $10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Re: Vender # 62505; Orange County Task B Transportation Plan. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County Planning & ACCORDANCE WITH THE POLICY PROVISIONS. Inspections Department Abigaile Pittman AUTHORIZED REPRESENTATIVE 131 W. Margaret Lane Suite 201 Hillsborough, NC 27278 Gregg Bundschuh/CARLY ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 rgninnFt m The ArOPn namc and Innn arc rcnictcrcri mnrlrc of AC(1Rr)