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DocuSign Envelope ID:622E9DC1-81`03-4131C-AA8A-11 C1D46D7FEA
<br /> ►R e
<br /> CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDPYYYYI
<br /> Imo- 041301201 s
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON I 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 policy(ias) 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 lieu of such endorsemDnt(s),
<br /> PRODUCER _ AOiI.AL:i. Array^H.Pasc'flal.. .�. ..�..
<br /> Ken B.Lawson,Jr. Extl 919-846-2090 �NXrNNo 919-846.2438
<br /> dba Lawson insurance Group,Inc, E-MAIL ADDRESS: pa'schaa o n,at0onwide.cont,
<br /> 6812-101 Six Forks Road INSURERISI AFFORDING COVERAGE NAICN
<br /> Raleigh,INC 27615 INSURERA s Natlonwvide Mutual Insurance Company 23787
<br /> INSURED INSURER B: AmGUARD(Insurance Company 21873.._.
<br /> ProNet Systems,Inc, INSURrmc Nationwide Mutual Fire Ins Company 23779
<br /> 320D Glen Royal Road INSURER O:
<br /> Suite 1017 INSURER E:
<br /> Raleigh,NC 27617 INSURER F
<br /> COVERAGES CERTIFICATE NUMBER; REVISION NiU R�MBE
<br /> THIS VS TO CERTIFY 'rHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN EID_PSSU 1.0 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM( OR CONDITION OF ANY CONTRACT OR GATHER DOCUMENT WITH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT"r'O ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> Nsi ADt1L-S Ir R POLICY EFF POLICY EXP
<br /> I TR'. TYPE OF INSURANCE PCY LYC�Y NUMaER lMMIDDfYYY`Y) IMwcrWYYHY9 LIMITS .......
<br /> A, X COMMERCIAL GENERAL LIABILITY Y Y ACP2272994383 02/221201502122/2016 rfGHvr,c,Il r,rxlN I S 1,000,000
<br /> t�wMla l r r¢nf r*Ira 100 000
<br /> �t�rlw�m`.ptIaq X r'"R',d�I4� aCYV, ,fRraor,�a, el 5
<br /> X Contractual Llabili I EkYC"vfAro,y rr pw s r�l $ 6,000
<br /> X Contractors(Enhancement PI warc.NM nn VIN.pURY 3 1,000,000
<br /> r.. _
<br /> �n, AGG�raGAT��I_uMir At"tw..nE;E PEra C'e5.045r2RrI.A(�r;Rer;aTE .$ 2,00I0,000
<br /> "tta;I 2 000 000
<br /> f�wwroLlc,Y X . :�:T ;I�at'a ��"ROtaY,i),I.E-ca�a��rc.arn�e�l S y
<br /> rrrrlE,R
<br /> _. ....._.... ...
<br /> C AUTOMOBILE,LIABILITY Y Y ACP3006921314 1213112015112131 12016,„rte��c�w�° 'wa'I° Ilwa'a s 1,000,000
<br /> IX ANY AUIC ',, FiOr kI_"t INJURY IPme ,w.:,in) S
<br /> AL 'OWNED SCHEDULED _ ...
<br /> I X AUL OS AUTOS RODLY tlNIJURY IFler ai;.cKfkrnlN S
<br /> I*N•T>um1NL.L” till:?}°E T Y D/tM14F+0E
<br /> i X FIiI'F'F'ET,141I x: X r)h1 DS fuo+r dC✓L'iw.h..'Itll .•S
<br /> ACP2799438 02d21205,02122206 El,1 1CGUPoREhCE A X UMBRELLA LIAR $ 4,000,000
<br /> X EXCESS LIAR kCLAIMS r AO ,T<,aIlsEtEAIE S 4,000.,000
<br /> 0FD X Rr, EN7*NS none -
<br /> ANDFEM PLOVERS I.IIARBIq ETh ,E:.Y:',C„�i"owa. NrA ..`. __ .._.....___..._.
<br /> B waoRhlll aoISPENSAnON `lrn PRWC663376 04/03/201504/0312016 X YHTF °
<br /> YIN
<br /> r w FA HAy t�CE T $ 1,000,000
<br /> OFF lMandarory In NH) '..-'..."'
<br /> r c.I�rISs,Y t E'AEW U)Y1 E.x 1,000,000
<br /> [ ,(RI PTSti)I OP E¢'"I":T"A 6 IONS ttm�o. L L DS EASE-POLICY iJW T S 1 000,0100
<br /> DESCRIPTION OF OPERATIONS;LOCA'nONS Y'VEHICLES (ACORD 161,Additional Remarks Schedu1o,may be attached If mows apace.Is raqulradl
<br /> Orange County Is Included as additional insured and Waiver of Subrogation applies per Blanket Contractors Enhancement
<br /> Endorsement CG 72 88 under the general liability pollcy, The Umbrella/Excess Liability policy is"follow forth"(please refer to
<br /> attachment). Blanket Waiver of Subrogation also applies to the workers compensation policy(please refer to attachment).
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE. THEREOF, NOTICE WILL BE DELIVERED IN
<br /> P.0,Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Hillsborough,NC 27278
<br /> AUTHORIZED REPR'ES,,NTA f
<br /> E-Mail: teomar @orangecountync.gov �^
<br /> I E Mall atf ronets! temslnc.com "
<br /> 0A 1 68-2014 XCORD CORPORATION. All rights reserved.
<br /> ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
<br />
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