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DocuSign Envelope ID: 50EA413D- 9AE9- 47BA- 95F7- 1C4F32076552 <br />AoCC)RE0 ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDsYYY) <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 have ADDITIONAL INSURED provisions or be endorsed. <br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER CONTACT <br />Marsh & McLennan Agency LLC PHONE Elaine Gray, CIC, CPSR FAX <br />3625 N. Elm St. INC. No- Fxij: 336 - 272-7161 (A/C, No): 336- 3_46 -1397_ <br />Greensboro NC 27455 E -MAIL DDR Elaine.Grayi <br />AESS: g mars hmma.com <br />INSURED <br />Learning Environments, Inc <br />Mr. Greg Keene <br />PO Box 1127 <br />Liberty NC 27298 <br />INSUREWSS AFFORDING COVERAGE NAIC # <br />INSURER A: Cincinnati Insurance Co. 10677 <br />LEARN -2 INSURER B: Accident Fund Insurance 10166 <br />INSURER C : <br />INSURER D : <br />INSURER E: <br />COVERAGES CFRTIFICATF NIIMRFR• 1n11A1n959 RF \ /ISIAAI NIIIMRCR• <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 <br />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� <br />LTR TYPE OF INSURANCE POLICY NUMBER <br />POLICY EFF POLICY EXP <br />MM /DDNYYY'i (MM /DD/YYYYI LIMITS <br />A X COMMERCIAL GENERAL LIABILITY Y EPP 0124499 <br />_ <br />2/2/2018 202019 EACH OCCURRENCE $ 1,000,000 <br />_ _ <br />DAMAGE TO RENTED <br />CLAIMS -MADE � OCCUR <br />PREMISES JEa occurrence $ 500,000 <br />X Contractual <br />MED EXP (Any one person) $10,000 <br />X , Independent Cont _ _ _ <br />PERSONAL & ADV INJURY $1,000,000 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE $2,000,000 <br />POLICY ] jRa LOC <br />PRODUCTS - COMP /OP AGG $ 2,000,000 <br />OTHER: <br />$ <br />A AUTOMOBILE LIABILITY EBA 0124499 <br />2/2/2018 21212019 COMBINED SINGLE LIMIT <br />$ <br />_IEa accident _____ . 1 000 000 <br />X ANY AUTO <br />BODILY INJURY (Per person) $ <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY INJURY (Per accident) $ <br />X HIRED X NON -OWNED <br />PROPERTY DAMAGE $ <br />AUTOS ONLY AUTOS ONLY <br />iPer accident] <br />A X UMBRELLALIAB X EPP 0124499 <br />OCCUR <br />21212018 2/2/2019 I EACH OCCURRENCE $ 5,000,000 <br />EXCESS LIAB CLAIMS -MADE <br />AGGREGATE $5,000,000 <br />DED X RETENTION $ L, <br />$ <br />_ <br />B WORKERS COMPENSATION Y WCV6016654 <br />2/212018 2/2/2019 X STATUTE , ERH <br />AND EMPLOYERS' LIABILITY Y/ N <br />ANYPROPRIETOR/PARTNER/EXECUTIVE <br />E.L. EACH ACCIDENT $ 500,000 <br />OFFICER/MEMBER EXCLUDED? N / A <br />- <br />(Mandatory inNH) <br />E.L. DISEASE - EA EMPLOYEE $500,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT $ 500,000 <br />A ' Installation Floater EPP 0124499 <br />2/2/2018 2/212019 Per Job 1,000,000 <br />A Cont Equip- Leased EPP 0124499 <br />I <br />2/2/2018 2/212019 Rented 50,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Project: Orange County Sports Plex <br />Orange County is included as additional insured with respect to general liability when required by written contract. Waiver of subrogation applies to workers <br />compensation when required by written contract. <br />L,CK 111 -11,A I C 11ULUCK I,iANt,.CLLA I IUN <br />Orange County <br />PO Box 8181 <br />Hillsborough NC 27278 <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 />AUTHORIZED O�RIZE_D R NTAT <br />©1988 -2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />