2016-534-E Housing - Terraquest Environmental Consultants, P.C. for consulting services

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DocuSign Envelope ID:2E2A8C23-2FC2-4842-9D7F-FA4A647151 F7 � •..r••�'^� TERRENV-01 JROBINSON A l-...C)RO DATE(MMIDDP(YYY) �. CERTIFICATE OF LIABILITY INSURANCE 9/16!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 NAME: Rogers insurance Agency PHONE 362 FAX 512 W Williams Street (A/C,No,EMI:(919) 8310 (Arc,Noy(919)362-4101 Apex,NC 27502 E-MAIL in A fo ro ersinc,net P ADDRESS: � g INSURER{S)AFFORDING COVERAGE NAIC# INSURER A:Evanston Insurance Company 35378 INSURED INSURER e:Penn National Security Insurance Company 32441 • Terraquest Environmental Consultants PC INSURER C C. Pennsylvania National Mutual Casualty Insurance Company 14990 100 East Ruffin St INSURER D: Mebane,NC 27302 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 ADDLISUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE I INSR I WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 15PKGSE20338 11101/2015 11/01/2016 DRMGE O{E RoNcTuErD e ne) $ 100r 000 X Pollution MED EXP(Any one person) $ 25,000 X Professional PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 POLICY PRO- JECT LOC PRODUCTS COMP/OP AGG .$ 2,000,000 OTHER: CONTRACTORS POL ' $ 1,000,000 AUTOMOBILE LIABILITY CO BINEDt1 INGLE LIMIT $ 1,000,000 B ANY AUTO AX90723808 09/11/2016 09/1112017 BODILY INJURY(Per person) $ y ALL X AUTOS OWNED AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Par accident) $ 1 X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESSLIAB CLAIMS-MADE 15EFXSE20195 11/01/2015 11/01/2016 AGGREGATE $ 1,000,000 DED RETENTIONS $ 'WORKERS COMPENSATION X STATUTE OTH- ER AND EMPLOYERS'LIABILITY C ANY PROPRIETOR/PARTNER/EXECUTIVE Y 1 N WC90723808 09/11/2016 0911112017 E.L.EACH ACCIDENT ,$ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (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 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101 Additional Remarks Schedule may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Housing Human Rights and Community THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Development 300 W.Tryon Street Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE t y� Cart 4v►y I ©1988-2014 ACORD CORPORATION All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD