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DocuSign Envelope ID:A8FA8021-DDC1-443A-BE32-DD6F94859130
<br /> ROYAL-5 OP ID:TL
<br /> CERTIFICATE OF LIABILITY INSURANCE
<br /> DATE
<br /> 08/06/201YYI
<br /> 08/05/2015
<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 /> 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 pollcy(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 /> certificate holder in Ileu of such endorsement(s).
<br /> PRODUCER NAME 7
<br /> Tammy L.Coolidge
<br /> Senn Dunn-Raleigh PHON FAX
<br /> 4700 Falls of Neuse Rd,St 190 (AIC.No Ex1:919-719-9861 Arc No); 919-372-3716
<br /> Raleigh,NC 27609-2521 -MAIL ADDRESS:tcoolidge@seniiduiiii.com
<br /> James P.Lowrey
<br /> INSURERS AFFORDING COVERAGE NAIC_G
<br /> INSURER A:Selective Insurance Co of Amer 12572
<br /> INSURED Royalwood Associates, Inc, INSURER B:Builders Mutual Ins.Co. 10844
<br /> Attn: Don Eidson-CEO — _.. _ _ ._ _ _
<br /> P.O,Box 91145 INSURER C:_
<br /> Raleigh,NC 27675-1146 INSURER D:
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS
<br /> W
<br /> LTR D POLICY NUMBER MMfDD1YYYY MM1DDlYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
<br /> _ DAE Ea umCLAIMS-MADE �OCCUR S1931429 0410112016 04/0112016 PREMI SES(Ea c,cDrran ce) � 100,000""-
<br /> MED EXP(Any one person) $ 5,00
<br /> PERSONAL&ADV INJURY S 1,000,00
<br /> GEN'LAGGREGATE LIMIT APPLIES PER GENFRALAGGREGATE 5 3,00_0,00
<br /> POLICY a JECT ❑LOC PRODUCTS-COMPIOP AGG $ 3,000,00
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY CO"A BINEt3 SINGLE LIMIT $ 1,000,000
<br /> Ea accidonl
<br /> A IX ANY AUTO ___ 04101/2016 04/01/2016 BODILY INJURY(Per person) 5
<br /> ALLOWNED SCHEDULED BODILY INJURY(Per aoddent) $
<br /> AUTOS AUTOS
<br /> HIRED AUTOS NON-OWNED PROPI_RTYDAMAGE AUTOS S
<br /> Per accident
<br /> $
<br /> X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 6,000,000
<br /> A EXCESS LIAa CLAIMS-MADF S1931429 04/01/2016 0410112016 AGE
<br /> GRGATE $ _ 5,000,00
<br /> DED I X I RETENTIONS 0 S
<br /> - WORKERS COMPENSATION X STATUTE _ OR H
<br /> AND EMPLOYERS'LIABILITY
<br /> B ANY PROPRIETOMPARTNERIEXECUTIVE YIN WCP102439602 04101/2015 04/01/2016 E.LFACHACCIDENT 5 1,000,00
<br /> OFFICEELMEMBER EXCLUDED? NIA
<br /> (MandaloryinNH) E.L.DISEASE.EAFMPLOYEE $ 1,000,00
<br /> If Yyes,describe under
<br /> DFSCRIPTIONOFOPERATIONSbelow E.L.DISEASE-POLICYLIMIi I S 1,000,00
<br /> DESCRIPTION OF OPERATIONS r LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is requi(ed)
<br /> Orange County Dept.of Environment,Agriculture, Parks&Recreation are
<br /> Included as additional insureds with regards to general liability as stated
<br /> in the policy language with written contract prior to any loss.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORAN818
<br /> SHOULD ANY OF THE ABOVE DESCR48ED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange County Dept, of ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Enviornment,Agriculture,
<br /> AUTHORIZED REPRESENTATIVE
<br /> Parks&Recreation
<br /> PO Box 8181 ��s
<br /> Hillsborou h NC 27278
<br /> ©1988.2014 ACORD CORPORATION. All rights reserved.
<br /> ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD
<br />
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