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DocuSign Envelope ID: 78EE5ED3-1EEE-40CF-A7C1-433DD817F9AF <br /> ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> �,.,.,. 10/13/2017 <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 <br /> NAME: <br /> PHONEFAX.............................................................................................. <br /> (A/C,No,Ext): (NC,No): <br /> Andrew F.Jones E-MAIL <br /> ADDRESS: <br /> 729 W NC HIGHWAY 54 INSURER(S)AFFORDING COVERAGE NAIC# <br /> DURHAM NC 27713 INSURERA: NATIONWIDE PROPERTY AND CASUALTY INSUF 37877 <br /> INSURED INSURER B: <br /> INSURER C: <br /> CIVIL CONSULTANTS, INC INSURERD: <br /> 3708 LYCKAN PKWY STE 201 INSURER E: <br /> DURHAM NC 27707-2586 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 TYPE OF INSURANCE ADDL W POLICY EFF POLICY EXP <br /> VD POLICY NUMBER LIMITS <br /> (MM/DD/YYYY) (MM/DD/YYYY) <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE X OCCUR PREMISES,,,(Ea occurrence) $ 300,000 <br /> MED EXP(Any one person) $ 5,000 <br /> A ACP BPOK 3036630836 04/24/2017 04/24/2018 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY PRO X <br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION II PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N `STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E .EACH ACCIDENT $ <br /> OFFICER/MEMBEREXCLUDED? N/A ....... ......... ......... ......... ......... ......... ......... <br /> (Mandatory in NH) E .DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E .DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County Asset Management Services <br /> AUTHORIZED REPRESENTATIVE <br /> 131 West Margaret Lane Diane M Burgess <br /> Hillsborough NC 27278 Og <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />