Orange County NC Website
DocuSign Envelope ID:4DA7C804-68DE-4OC2-A41 F-92032E351676 <br /> „�. 0 DATE IMWDIDtYYYY) <br /> ,�► <br /> CERTIFICATE OF LIABILITY IN'S'URANCE; 4/2902015 <br /> THIS CERTIFICATE IS ISSUED AS A 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 /> BELOWW. 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 elndlorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT Patty Miller <br /> NAME: <br /> Business Insurers Of Carolinas PHGNE (91.9)968-461& FA� No.(91919 68-8992 IA N <br /> 600 Eastowne Drive, Suite 206 A E-MAIL S;pomIausines-insurers.cram <br /> PO Box 2536 INSGJRER(S�AF�ORpIFN�aCOVERAGE NAWD# <br /> Chapel Hill C 27515-2536 INSURER A.Continental Western -...........10804 . <br /> INSURED INSURER R:»+r'tone ood Ins. Co. 11626 <br /> _..__...�__....m............., _.._........., _ ._..... .........._. <br /> Corley Redfoot Architects, Inc INSURER C: <br /> 2.22 Cloister Court INSURER D: <br /> INSURER.E: <br /> Chapel Hill NC 27514 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER-.2014-2015 REVISION NUIMIBER,:'. <br /> THIS IS TO,C'ERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED, t^NOTVVIT'HSTANDIiNG 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 CO NDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> _ ...... ... ............,...,_,_..... <br /> , <br /> INS.kz. -__.____..___TYPE OFINSURANCE AODL�fSk�Na.., POLICY NUMBER MM DrYYYY (MMID&YYYY�..-�._. .. LIMITS <br /> L'rI2 <br /> GENERAL LIABILITY EACH OCCURRENCE 3 1,000,010.0.. <br /> IA"l IU NL�TLro <br /> MMIrb'rVAL GENERAL LIABILITY' I F r?.EI�9B,�L'��I=�rsccLrrrerbcey S...... 100,000... <br /> rt°,r) <br /> .. ......,.._,. ._. <br /> A CLAIMS-MADE FOC�.CUP PA1008189 47 7 f9/2014, /9/2015 ME:r.71;CPIAnya1P-, PL-:••n) S 10,000 <br /> PEr�SSaNAa�,ACr^IN�L�I�Y � <br /> GENERAL.AGGREd'..E.A°f C: 2.000,000...... <br /> GEN'LAGGREGATE LIMIT APPUES PER PRODUCTS,C(JM1+'M1FFCWAC.,K; $ 2,000,000 <br /> .X I TrC uuy FFtC:r., LOC S <br /> AUTOMOBILE LIABILITY CONINNED SMGLF LIMIT <br /> EaaT <br /> $ 000 0001 <br /> A ANY AUTO BODILY INJURY(Per person) S ________................._.., <br /> AIAG;MJED SCHEDULED CPA1008189 47 /9/2014 /9/2015 g3 ILYm"uPY(Peracciderl:6y $ <br /> AUTOS AUTOS. <br /> NQN-0VMED PROPERTY'OA.M,AGE. <br /> HoRED ALTO', AUrDE; ALI.[aAcl crrrrrll.�................ ..� <br /> Dht Isuved rmoN.Ost Eta IuL Ilmll 1,000,000 <br /> X UMBRELLA HAS X OCCUR mbrcIla policy follows EACH OCCURRENCE 51 2,000,000 <br /> A EXCESS LIAR---- s;LAIM...MACE Oran DL, Auto we c cs�Er:;Arl _ 2,000,000, <br /> tl1t'D X RE ENTIOhUS EA10081E9 47 /9/2014 /9/2015 T <br /> I <br /> WORKERS COMPENSAT10N <br /> " WCSTATU- <br /> AND EMPLOYERS"LIABILITY YdN LSi LLMi1a _c?RrPi- <br /> �.. <br /> ANY rA7PRIF ro!R�PARI IWER EXE('�UTIVE EL IEAC' AC.�W,RDET4r '3 s!o OOO <br /> C."brHC:E6A'P',IEL SE.R EXCLUDED? [1'� NIA ...._ ..,�...m� _...,._.._�_,,..�s ,.,�__, <br /> (MastdataryInNH) C10000022052014A 12/31/20141,2/31/2015 EL DISEASE-EAEMIPLOYE: E 500,000 <br /> U yyes,desrrnbe uanuer <br /> ESCRIPTIONOF OPFRAIPCINSbellow+ ...._.........., .......... ......... .... .E:.UL MS EA L:.IO PCYLImir S 5.001—.9100 <br /> DESCRIPTION OF OPERATIONS r LOCATIONS t VEHICLES (Attach ACORD 101,Additional Remarks Schedule„IF mare space 8s required) <br /> Project: 1.1.3 Mayo Street project <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ie:s) must be endorsed.. If <br /> SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an <br /> ,endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of <br /> :such endorsement(s) . <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY'OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WELL BE DELEVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS, <br /> Orange Count* <br /> PO Box 6181 <br /> Hillsborough, NC 272..76 AUTHORIZED REPRESENTATIVE <br /> Patty Miller/PATTY <br /> ACORD 25(2010105) 1988-2'010 ACORD CORPORATION. All rights reserved. <br /> INS025 i ntnn5'; m T ho A(:1'"Pn nomn a nrI Ilnnn ern rraniatcarnri m—ke ref er.r)Pn <br />