2016-143-E DEAPR - Legacy Research Associates, Inc. for Blackwood Farm archaeological survey of slave cemetary

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DocuSign Envelope ID:7F60E54E-C475-4A87-8A4B-CBC487C92B77 q ^--•� LEGAC-1 OP ID: CH CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 02/01/2016 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 First Insurance Services,Inc. NAME: PHONE FAX P.O.Box 13687 A/C No Ext: A/C No): RTP,INC 27709 E-MAIL Robert M.Good ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Hartford Casualty Insurance Co 29424 INSURED Legacy Research Associates Inc INSURER B: 125 West Woodridge Drive Durham,NC 27707 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 DDL UBR POLICY EFF POLICY EXP LIMITS LTR D POLICY NUMBER MM/DD/YYYY MMIDD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 2,000,00 • COMMERCIAL GENERAL LIABILITY X 22SBAL05758 03116/2015 03/16/2016 DAMAGE Ea EN ED occurrence) $ 300,00 CLAIMS-MADE F-I OCCUR MED EXP(Any one person) $ 10,00 X Business Owners PERSONAL&ADV INJURY $ 2,000,00 GENERAL AGGREGATE $ 4,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,00 POLICY P - LOC $ JECT RO AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,00 Ea accident $ • ANY AUTO 22SBAL05758 03116/2015 03/1612016 BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON-OWNED PROPERTY DAMAGE $AUTOS X HIRED AUTOS X AUTOS PER ACCIDENT UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY X TORY LIMITS ER • ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 22WBCCM2318 03/14/2015 0311412016 E.L.EACH ACCIDENT $ 500,00 OFFICER/MEMBER EXCLUDED? N NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Orange County Dept of Environment, Agriculture and Parks & Recreation are listed as additional insureds if required by a written/executed contract or agreement prior to a loss. CERTIFICATE HOLDER CANCELLATION COUNTY3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orana County Dept THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g tY p ACCORDANCE WITH THE POLICY PROVISIONS. of Environment Agriculture &Parks&Recreation AUTHORIZED REPRESENTATIVE Box 8181 Hillsborough,NC 27278 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD