DocuSign Envelope ID: FC33DOBE- 4D4D- 45AF- 857C- 2498EBC91861
<br />Client #: 25609
<br />PENTENGI
<br />ACORDT. CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM /DDYY)
<br />10/04/2017
<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
<br />Greyling Ins. Brokerage /EPIC
<br />3780 Mansell Road, Suite 370
<br />Alpharetta, GA 30022
<br />NAMEACT Katie Kresner
<br />PHONE 770.552.4225 FAX 866.550.4082
<br />A/C, No, Ext : AIC, No
<br />Katie.Kresner @greyling.com
<br />-ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIC #
<br />INSURER A: Nautilus Insurance Company
<br />17370
<br />EACH OCCURRENCE
<br />INSURED
<br />Engineering Group, Inc.
<br />INSURER 13: Great Divide Insurance Company
<br />25224
<br />Ohio Security Insurance Company
<br />INSURER C : Y p Y
<br />24082
<br />4000 Miller Court West
<br />4000 M
<br />Norcross, GA 30071
<br />INSURER D:
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY ® JEt° [�] LOC
<br />OTHER:
<br />INSURER E:
<br />$2,000,000
<br />INSURER F:
<br />$2,000,000
<br />COVERAGES CERTIFICATE NUMBER: 17 -18 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
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDL
<br />INSR
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MM /DD /YYYY
<br />POLICY EXP
<br />MM /DD/YYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE ® OCCUR
<br />ECP201603712
<br />10/08/2017
<br />10/08/2018
<br />EACH OCCURRENCE
<br />$1,000,000
<br />PREMISES EaoNcurrence
<br />$100,000
<br />MED EXP (Any one person)
<br />$ 5,000
<br />PERSONAL & ADV INJURY
<br />$1,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />POLICY ® JEt° [�] LOC
<br />OTHER:
<br />GENERAL AGGREGATE
<br />$2,000,000
<br />PRODUCTS - COMP /OP AGG
<br />$2,000,000
<br />$
<br />C
<br />AUTOMOBILE
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED SCHEDULED
<br />AUTOS AUTOS
<br />HIRED AUTOS X NON -OWNED
<br />AUTOS
<br />BAS1858312554
<br />10/08/2017
<br />10/0812018
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />1,000,000
<br />X
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />$
<br />X
<br />PROPERTY DAMAGE
<br />Per accident
<br />$
<br />A
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />[;JO
<br />CCUR
<br />LAIMS -MADE
<br />FFX201603812
<br />10/08/2017
<br />10/08/201
<br />EACH OCCURRENCE
<br />$5,000,000
<br />�(
<br />AGGREGATE
<br />s5,000,000
<br />DED I X RETENTION $O
<br />$
<br />B
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N
<br />OFFICER/MEMBER EXCLUDED? ®
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />N/A
<br />WCA201603612
<br />10/08/2017
<br />10/08/2018
<br />X PER OTH-
<br />E.L. EACH ACCIDENT
<br />$1 000,000
<br />E.L. DISEASE - EA EMPLOYEEI
<br />$1,000,000
<br />E.L. DISEASE -POLICY LIMIT
<br />1 $1,000,000
<br />A
<br />Professional Liab
<br />Contractors Poll.
<br />Liability
<br />ECP201603712
<br />ECP201603712
<br />10/08/2017
<br />10108/2017
<br />10/081201
<br />10/08/2018
<br />Per Claim /Agg $1 M /$2M
<br />PerCondition $1,000,000
<br />Aggregate $2,000,000
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Excess Liability includes Professional Liability, Contractors Pollution Liability, and CGL. Professional
<br />Liability in primary and Excess policies is claims -made. Aggregate Limits of $2,000,000 in primary CGL, PL
<br />and CPL applies to all three coverage parts. Aggregate limit of $5,000,000 in Excess Liability applies to
<br />CGL, PL and CPL.
<br />Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />PO BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS.
<br />Hillsborough, NC 27278
<br />AUTHORIZED REPRESENTATIVE
<br />©1988 -2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br />#S8720181M871590 KKRE1
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