2016-139-E DEAPR - ATC Associates of NC, PC for geotech services

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DocuSign Envelope ID:OAF 1 2925-8959-4001-86A5-0644A8C56FE 1 ® [=1'2/9/D01 Y) 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 w certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Aon Risk Services Southwest, Inc. PHONE FAX Houston TX Office C.No.Ext): (866) 283-7122 A/C No : (800) 363-0105 $ 5555 San Felipe E-MAIL p Suite 1500 ADDRESS: y Houston TX 77056 USA INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: Steadfast Insurance Company 26387 ATC Group Services, LLC INSURER B: Zurich American Ins CO 16535 221 Rue De Jean Suite 200 INSURER C: Lafayette LA 705083283 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:570060355091 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYWY MMIDOIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLP EACH OCCURRENCE $2,000,000 CLAIM&MADE X❑OCCUR AM RE D $100,000 PREMISES Ea Occurrence MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $2,000,000 rn GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $6,000,000 X POLICY ❑JEC DLOC PRODUCTS-COMP/OPAGG $4,000,000 m OTHER: o ti B BAP-0217109-00 11/13/2015 11/13/2016 COMBINED SINGLE LIMIT r' AUTOMOBILE LIABILITY $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) 0 ALL OWNED SCHEDULED BODILY INJURY(Per accident) AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE V AUTOS Per accident u- d A UMBRELLA LIAB X OCCUR 5X5021707700 11/13/2015 11/13/2016 EACH OCCURRENCE $20,00015-0-0 U X EXCESS LIAB CLAIMS-MADE AGGREGATE $20,000,000 DED RETENTION B WORKERS COMPENSATION AND WCO21711100 11/13 2015 11 13 2016 X PER OTH- EMPLOYERS'LIABILITY Y/N STATUTE I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 ❑ N/A OFFICER/MEMBER EXCLUDED, N (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 A Contractor Poll GLP021708500 11/13/2015 11/13/2016 Policy Aggregate $6,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder: orange County, Department of Environment, Agriculture, Parks and Recreation. CERTIFICATE HOLDER CANCELLATION v SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE ti POLICY PROVISIONS. orange County AUTHORIZED REPRESENTATIVE .- Attn: Marabeth Carr, ASLA Landscape Architect 306A Revere Road PO BOX 8181 Hillsborough NC 27278 USA = ©1988-2014 ACORD CORPORATION.All rights reserved. ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD