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DocuSign Envelope ID: FE6ABADE- 4796- 489E- B5FB- F5DEBE14B90C J`1L. f\ ®® C ". CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYI 027412018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. It SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsament(S). PRODUCER CONTACT TRACY MEADOWS NAME: INSURE H NNo Exc; (919)781 -1115 AX, No : (919)7836427 2507 GLENWOOD AVENUE (27608) } -MAIL TMEADOWSQINSURE- NC.COM ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC M PO BOX 315cs INSURER A: TRAVELERS INDEMNITY OF CONNECTICUT RALEIGH NC 27622 INSURED INSURER B: TRAVELERS CAS INS CO OF AMERICA CLAIMS -MADE k - -1 OCCUR INSURER c. TRAVELERS INDEMNITY COMPANY DESIGN DIMENSION INC INSURER D - 901 NORTH WEST STREET INSURER E; 3 300,0017 RALEIGH NC 27603 INSURER F: $ 5,000 COVERAGES CERTIFICATE NUMBER: Std -17118 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMlIIDfYYYY MMMP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE k - -1 OCCUR PREMISES Ea o menrj 3 300,0017 WD EXP (Arty nne arson ) $ 5,000 PERSONAL &AD'VINJURY $ 1,000,000 A 1- 850- 7A930152 -TCT 1012512017 1012512018 GEN'L AGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE S 2,000,000 is ET ❑ LOC POLICY 171 J PRODUCTS- COMPIOP AGG S 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMONED SINGLE LIMIT Ea aradent 3 1,000,000 BODILY INJURY (Per penwn) 3 x ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS BA- 7A387415 1012512017 10125/2018 Bo-NLY INJURY {Par ao ident) $ PROPERTY DAMAGE Per ecddent $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X UMBRELLA LIAB � .00CUR EACH OCCURRENCE $ 1,0N,000 EXCESS LIAR CLAIMS-MADE CUP- 7A93O335 10125/2017 10/2512018 AGGREGATE $ 1,000,000 DED RETENTION S $ T,ANY WORKERS COMPENSATION EMPLOYERS' IJABILITY YIN PROPRIETORIPARTNER7EXECUTIVE ICIERUFMBER EXCLUDED? El (Mandatory in NH) NIA IH- UB- 7A36701 -0 10/25/2017 14/2512018 STATUTE �R E-L EACH ACCIDENT 3 1 =0D4,400 E,L, DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,004,001] DESCRIPTION OF OPERATIONS; LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is ntquired) Lei �t tlltL�7�t3�ii1�3_U.3.i ORANGE CC DEPT OF ENVIRONMENT, AGRICULTURE, PARKS AND RECREATION PO BOX 8181 HILLSBOROUGH NC 27278 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 0 1988 -2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD