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DocuSign Envelope ID: 7E6ED4B7- 97A8- 4F25- 9CCE- 5025EA633974 <br />ACC>R6r CERTIFICATE OF LIABILITY INSURANCE <br />111I.� <br />DATE(MMRIDIYYYY) <br />1 4127/2018 <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(iss) 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 dogs not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />BB &T Insurance Services, Inc. <br />2108 W. Laburnum Ave Suite 300 <br />PO Box 17370 <br />CONTACT Krevonick <br />678 -5026 AIC FJo� 7�J I °fl14 <br />k. <br />nick bbandt.com <br />Richmond VA 23227 <br />INSURER$ AFFORDI NGCOVERAGE <br />NAIC9 <br />lers Indemnity Company <br />25658 <br />INSURED 36MOSELARC <br />Moseley <br />Mosey Architects PC <br />3200 Norfolk Street <br />INSURER B: Travelers Property Casualty CO of Amer <br />25674 <br />INSURER c: Travelers Casualty & Surety Company <br />19038 <br />INSURER O. XL Specialty Insurance Company <br />37885 <br />Richmond VA 23230 <br />INSURER E: <br />MED EXP (Any one Icon <br />$10,000 <br />INSURER F; <br />COVERAGES CERTIFICATE NUMBER: 1519991604 REVISION NUMBER' <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />_ <br />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADUL <br />BURR <br />- <br />POLICYNUMBER <br />POLICY EFF <br />M DD <br />POLICY E7kP <br />MM o O <br />LIMITS <br />a <br />x <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />6BOGJ6764141947 <br />6/6/Y018 <br />5/8=18 <br />EACH OCCURRENCE <br />$ 1,00a,OW <br />_ <br />PREMISES (Es - nee ) <br />$1,000,000 <br />MED EXP (Any one Icon <br />$10,000 <br />- <br />PERSONAL & ADV INJURY <br />$1,000,900 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY E T ® LOC <br />{GENERAL AGGREGATE <br />$ 2,000,000 <br />PRODUCTS - COMP/OP AGG <br />$2,0_00,000 <br />$ <br />OTHER: <br />B <br />AUTOMOBILE <br />LIABILITY <br />BA1613L67310GRP <br />516/2018 <br />51612019 <br />COMBINED SINGLE LIMIT <br />Ea scclden <br />#1040,040 <br />X <br />BODILY INJURY (Per peman) <br />$ <br />ANY AUTO <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />BODILY IN ) <br />Y (Per Per secfdehk <br />$ <br />HIRED X NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />PROPERTYDAMAOE <br />Per aocldenl <br />A <br />x <br />UMBRELLALIAB <br />OCCUR <br />CUP6607Y21141847 <br />81612018 <br />5182016 <br />EACH OCCURRENCE <br />$8,9D0,000 <br />AGGREGATE <br />$ 6,000,000 <br />EXCESS LIAR <br />CLAIMS -MADE <br />DED I X I RETENTION <br />$ <br />C <br />WORKERS COMPENSATION <br />EMPLOYERS' LIABILITY YIN <br />ANYPR OI- RIETORJPARTNERIEXECUTIVE El <br />OFFICERIMEMBEREXCLUDED7 <br />NIA <br />UB4K8246221847E <br />5/1/2810 <br />611/2019 <br />x STAE PER ERH <br />AND <br />E.L. EACH ACCIDENT <br />$ I.WD,ODD <br />E.L. DISEASE - EA EMPLOYEE' <br />$1 DDD,DDD <br />(Mandatory In NH) <br />IF es, descrlhe under <br />DESCRIPTION OF OPERATIONS below <br />E.L. DISEASE - POLICY LIMIT <br />$1,000,ODD <br />D <br />Professional <br />Llsbwity <br />DPR9910305 <br />12fl/2017 <br />1211[2016 <br />Per Cialm <br />Agggrrssppate <br />$4,000,000 <br />$6,0D0,000 <br />Oe 7b'l'e <br />$200,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (ACORD 101, AddltlonalRemarks Schadulu, may be attachad if more space is regolmd) <br />Umbrella Liability does not extend over Professional Liability <br />Additional Named Insureds: <br />Moseley Architects PC <br />Moseley Scott's Addition LLC <br />Moseley Architects of Maryland Inc. <br />Moseley Architects North Carolina PC <br />Moseley Arrhitects of Virginia LLC <br />See Attached... <br />L-Icm I IrIL.A t r- nuLL r-m L.ANI.CLLA I IL)N <br />Orange County <br />PO Box 8181 <br />Hillsborough NC 27278 -2505 <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 REPRESENTATIVE <br />V.zz"Jlliil� <br />1988 -2015 ACORD CORPORATION. Ail rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />