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DocuSign Envelope ID:A9CF8A9E-4CDB-4BB9-A678-D4AD80CD1393
<br /> M/DD/YYYY)ACC)RL? CERTIFICATE LIABILITY INSURANCE
<br /> 6/23/20 16
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME; Mitzi Hines
<br /> NFP Corporates Services(SE), Inc. (A/C.No.Ext1:704-200-9399 FAX No1:704-973-9501
<br /> 1901 Roxborough Rd, Ste 300 i iCharlotte NC 28226 E-MAIL ass:mtz.hines of •com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Zurich North America 16535
<br /> INSURED BAKEROO INSURER B:American Guarantee&Liability 26247
<br /> Baker Roofing Company, Baker Renewable Energy, LLC INSURER C:XL Specialty Insurance Company '37885
<br /> Mercury Realty, LLC; JPB Holdings LLC; Baker South INSURER D:Zurich America Insurance 16535
<br /> Roofing Company, Inc.;Angel Wings 8 LLC
<br /> P O Box 26057 INSURER E:
<br /> Raleigh NC 27611 INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:1096948607 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VNTH RESPECT TO WHICH THIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP
<br /> LTR INSR WVD POLICY NUMBER (MM/DD/YYYY) (MMIDDIYYYY) LIMITS
<br /> A GENERAL LIABILITY Y GL00174014-02 7/1/2016 7/1/2017 EACH OCCURRENCE $1,000,000
<br /> X COMMERCIAL GENERAL LIABILITY PRMMGE TO RENTED
<br /> PREMISES(Ea occurrence) $300,000
<br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $10,000
<br /> X Contractual Liab PERSONAL&ADV INJURY $1,000,000
<br /> X XCU Included GENERAL AGGREGATE $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000
<br /> POLICY X JECT LOC $
<br /> D AUTOMOBILE LIABILITY BAP0174013-02 7/1/2016 7/1/2017 COMBIN S
<br /> (Ea accidenED t)INGLE LIMIT $1,000,000 _
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS (Per accident)
<br /> X Comprehensiv X Collision PD Deductible $1,000
<br /> B X UMBRELLA LIAB X OCCUR AUC5525043-04 7/1/2016 7/1/2017 EACH OCCURRENCE $10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED X RETENTION$10,000 $
<br /> A WORKERS COMPENSATION WC0174015-02 7/1/2016 7/1/2017 X WC STATU- 0TH- .
<br /> AND EMPLOYERS'LIABILITY YIN TORY LIMITS_ ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N NIA
<br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> ALease&Rented Equip CPP0174646-02 7/1/2016 7/1/2017 Per Item 150,000
<br /> C Builders Risk MBR0174648-02 7/1/2016 7/1/2017 Any One Project 3,000,000
<br /> Crime-Client Coverage ELU139752-16 7/1/2016 7/1/2017 Per Occurrence 1,000,000
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required)
<br /> Orange County is additional insured under the General Liability for work performed by the named insured for such additional insured, if
<br /> required by contract signed by an authorized representative of the named insured.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN i
<br /> P.O. Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Hillsborough NC 27278
<br /> AUTHORIZED REPRESENTATIVE
<br /> \ ©1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
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