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DocuSign Envelope ID: FF48DEF4- 4947 - 4635- BFE8- 100F3CAB52DC <br />® <br />AC[7R" CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MMIDDfYYYY) <br />��• <br />0211412618 <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 he 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 <br />CONTACT TRACY MEADOWS <br />NAME; <br />INSURE <br />PAil Ho (919)781 -1115 (919)783 -6427 <br />j o Esct A7C No : <br />2607 GLENWOOD AVENUE (27608) <br />E-MAIL SS; TMEADOWSOINSURE- NC.COM <br />ADDRE <br />INSURER(S) AFFORDING COVERAGE <br />NAIL s <br />PO BQ1i 3150$ <br />INSURER A : TRAVELERS INDEMNITY OF CONNECTICUT <br />CLAMS-MADE � OCCUR <br />RALEIGH NC 27622 <br />INSURED <br />INSURER 6: TRAVELERS CAS INS CO OF AMERICA <br />INSURER C: TRAVELERS INDEMNITY COMPANY <br />DESIGN DIMENSION INC <br />901 NORTH WEST STREET <br />INSURER O: <br />MED EXP (Any me parson) <br />RALEIGH NC 27603 <br />INSURER E; <br />3NSURE,R F : <br />COVERAGES CERTIFICATE NUMBER, Std -17118 REVISION NUMBER: <br />THIS I$ TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN tSSUED 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 />INSD <br />V;ND <br />POLICY NUMBER <br />POLICY EFF <br />MMA)D1YYYY <br />POLICY ERP <br />MMJDDPYYYY <br />LIMITS <br />HILLSBOROUGH NC 2727$ <br />X <br />COMMERCIALGENERALLIABIIJTY <br />EAGH OGGURRENGE <br />S 1,000,000 <br />CLAMS-MADE � OCCUR <br />PREMISES Ea oecurcence <br />$ 000,000 <br />MED EXP (Any me parson) <br />$ 5,400 <br />PERSONAL & ADV INJURY <br />$ 1,000,ODO <br />A <br />I-660- 7A930152 -TCT <br />10125/2017 <br />10r2512018 <br />GEN "L AGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />X POLICY ❑ JECT LUC <br />PRODUCTS - COMPIOP AGG <br />$ 2,000 =000 <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea acdden <br />$ 1,000,000 <br />BODILY INJURY (Per person) <br />$ <br />ANY AUTO <br />B <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />I <br />BA- 7A387415 <br />1 Df2512017 <br />10125/2018 <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />'Per aCCedent <br />$ <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />5 <br />X <br />UMBRELLA I" <br />OCGOR <br />EACH OCCURRENCE <br />$ 1,400,000 <br />AGGREGATE <br />$ 1,000,000 <br />(� <br />EXCESS LIAR <br />CLAIMS -MADE <br />CUP- 7A930336 <br />10125/2017 <br />1012512018 <br />DED I I RETENTION $ <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />AN PROPRi EFCRIPARTNER)EtECUTIVE <br />OFFICERIMEMBER EXCLUDED? <br />(Mandatory in NH) <br />N iA <br />II-I- U$- 7A38701 -0 <br />1012512417 <br />10125/2018 <br />PER <br />X STATUTE OER� <br />E,L. EACH ACCIDENT <br />y 1,000 =000 <br />E.L. DISEASE- EA EMPLOYEE <br />S 1,000,000 <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />E- L. DISEASE- POLICY LIMIT <br />S 1;000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 401, Additional Remarks schedule, may be attached if more space is required) <br />CERTIFICATE BOLDER CANCELLATION <br />C 1988 -2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ORANGE CO DEPT OF ENVIRONMENT, AGRICULTURE, <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />PARKS AND RECREATION <br />AUTHORIZED REPRESENTATIVE <br />PO BOX 8181 <br />HILLSBOROUGH NC 2727$ <br />C 1988 -2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />