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DocuSign Envelope ID: 1 B95167A-8F9A-49D6-BC56-CB311036EC45 <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 08/22/2017 <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 Christy Freeman <br /> AAI-Mark Vitali Agency PHONE,Ext): 919-933-4000 FAX,No): 919-933-5150 <br /> 1289 N. Fordham Blvd. E-MAIL freemc5 @nationwide.com <br /> ADDRESS: <br /> Chapel Hill, NC 27514 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURERA: NATIONWIDE MUTUAL INSURANCE CO. 23787 <br /> INSURED INSURERB: BUILDERS MUTUAL INS. COMPANY 50019 <br /> FRAZEE CARPET&INTERIORS, INC INSURERC: <br /> 3113 HILLSBOROUGH ROAD INSURER D: <br /> DURHAM, NC 27705-3002 INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 WITH 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE <br /> (MM/DD/YYYY) (MM/DD/YYYY) LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY ACP 228887341 05/09/2017 05/09/2018 EACH OCCURRENCE $ 2,000,000 <br /> DAMAGE RETE <br /> CLAIMS-MADE X OCCUR PREMISES O(Ea occur ence) $ 300,000 <br /> MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 2,000,000 <br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> POLICY 'X JECT LOC PRODUCTS-COMP/OP AGG $ 4,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY ACP 2283887341 05/09/2017 05/09/2018 O aBcideDt)INGLE LIMIT $ 2,000,000 <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> HIRED AUTOS X NON-OWNED PROPERTY DAMAGE <br /> AUTOS (Per accident) <br /> A X UMBRELLA LIAB OCCUR ACP 2283887341 05/09/2017 05/09/2018 EACH OCCURRENCE $ 4,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,000 <br /> DED RETENTION$ $ <br /> B WORKERS COMPENSATION WCP 0039270 10 02/16/2017 02/16/2018 O <br /> PEATUTE ETH <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N/A <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 /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County <br /> PO Box 8181 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Hillsborough, NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> Email: abarnes @orangecountync.gov Christy Freeman <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />