2016-340 Housing - Habitat for Humanity for FY 2014 HOME Funds

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1 ® DATE(MM/DD/YYYY) ACCOR° CERTIFICATE OF LIABILITY INSURANCE 3/24/2016 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 LOT1 MOell NAME: Summit Insurance Group, Inc. PHONE (704)659-2141 NC No:(709)659-2148 IAIC.PO Box 2485 E-MAIL ADDRESS:lmoell @sumins.com INSURERS AFFORDING COVERAGE NAIC# Huntersville NC 28070 INSURERA Builders Mutual Insurance Company - INSURED INSURERS: BE Insurance Corporation Habitat For Humanity Of Orange County, NC, Inc. INSURERC: 88 Vilcom Center Dr. Ste L110 INSURER D: INSURER E: Chapel Hill NC 27514 1 INSURER F COVERAGES CERTIFICATE NUMBER:CL1632402409 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 ADDL SUER POLICY NUMBER MM/DDY� MM/DDS LIMITS LTR X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE FX OCCUR DRE =S( RENTED 500,000 PREMISES Ea occurrence $ X CPP0058155 4/1/2016 4/1/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: Employee Benefits $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident A X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED pCA0009233 4/1/2016 4/1/2017 BODILY INJURY(Per accident) $AUTOS AUTOS NON--OWNED PROPER accidtDAMAGE $ HIRED AUTOS AUTOS Medical payments $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 A EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED X RETENTION$ 10 000 UM0025059 4/1/2016 4/1/2017 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 N/A OFFICER/MEMBER EXCLUDED? ❑N A (Mandatory in NH) WCP1024619 4/1/2016 4/1/2017 E.L.DISEASE-EA EMPLOYE $ 1 000 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,000 B Volunteer/Accident DI NHH000489 4/1/2016 4/1/2017 $250,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Orange County Department of Housing, Human Rights & Community Developement is considered additional insured with regards to the general liability per written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Department of Housing, THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Human Rights & Community Development ACCORDANCE WITH THE POLICY PROVISIONS. 200 S Cameron Street PO BOX 8181 AUTHORIZED REPRESENTATIVE Hillsborough, NC 27278 Lori Moell/LORI / ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 001401)