2016-486-E DEAPR - Legacy Research Associates - Amendment to contract re Blackwood Farm archaeological survey of slave cemetery

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DocuSign Envelope ID:9D7E7A6C-13EC-4E60-BBF2-A03BC04BB388 LEGAC-1 OP ID: CH DATE(MM/DD/YYYY) '`'c°R° CERTIFICATE OF LIABILITY INSURANCE �..._.-� 02/01r201 s 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. PHONE FAX P.O.Box 13687 (A/C,No.Ext): (A/C,No): RTP,NC 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 INSURER C: 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 ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MM/DDIYYYY) (MMIDDJYYYY) GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 A COMMERCIAL GENERAL LIABILITY X 22SBAL05758 03!16/2015 03/16/2016 PREMISES(Ea occurrence) $ 300,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 10,000 X Business Owners PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 4,000,000 —1 POLICY JECOT- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 (Ea accident) A ANY AUTO 22SBAL05758 03/16/2015 03/16/2016 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS - WNED PROPERTY DAMAGE N $ X HIRED AUTOS X AUTOS __(PER ACCIDENT) UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION INC STATU- OTH- AND EMPLOYERS'LIABILITY X TORY LIMITS ER Y/N A ANY PROPRIETOR/PARTNER/EXECUTIVE 22WBCCM2318 03/14/2015 03/14/2016 EL EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A N (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 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(2010/05) The ACORD name and logo are registered marks of ACORD