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DocuSign Envelope ID: 7A1 847E6-6A67-4915-9B30-D7E1 12028605 <br />A C CERTIFICATE QF LIABILITY INSURANCE DATEIMM1OUlYYYY) <br />04/0712017 <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 poficy(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 Am H. Paschal _ <br />NAME: y <br />Ken S. Lawson, Jr. PHONE EA), 919 - 846 -2090 ext 105 1 AIC;NoI. 919 -846 - 2438 <br />Ken Lawson, Jr. Agency nI opIrzss. paschaa @nationwide.com <br />8512 -101 Six Forks Road _ INSURERZS} AFFORDING COVERAGE NAIL q <br />Raleigh, NC 27615 INSURERAI Nationwide Mutual Insurance Company 23787 <br />INSURED INSURER 8, NoYGUARD Insurance Company 25844 <br />ProNet Systems, Inc. <br />3240 Glen Royal Road <br />Suite 107 <br />Raleigh. NC 27617 <br />COVERAGES CERTIFICATE NUMBER: REVISION NLIMRER- <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 pi INSURANCE <br />ADDL <br />SUER <br />POLICY NUMBER <br />POLICY EFP <br />MMIDDIYYYY <br />POLICY EXP <br />MMIDD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />Y <br />ACP GLO 2292994383 <br />02122120170212212018 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE I CCCUR <br />PREMISES.{ a oeeurrence <br />$ 100,000 <br />X <br />6,000 <br />Contractual Liability <br />MED EXP (An( tans person }$ <br />X <br />Contractor's Enhancement <br />1 S 1,000,000 <br />P_ERS_ONAL &AOVINJURY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />s 2,000,000 <br />GENERAL AGGREGATE <br />POLICY ECT � LOC <br />PRODUCTS - COMPIOPAGG <br />$ 2,000,000 <br />$ <br />OTHER: <br />AUTOMOBILE LIABILITY <br />COMaINEO SINGLE LIMIT <br />(Es- a_ccldenl <br />$ <br />S <br />ANY AUTO <br />BODILY INJURY (Per person) <br />OWNED SCHEDULED <br />AUTOS <br />AUTOS ONLY AUTOS <br />HIRED NON -OWNED <br />AUTOS ONLY AUTOS ONLY <br />INJURY (Pet accident) <br />PROPERTY DAMAGE <br />(Pat accident <br />- --- <br />S <br />$ <br />S <br />A <br />X <br />UMBRELLA LIAB <br />i€ <br />OCCUR <br />Y <br />ACP CAF 229994383 <br />02/2212017 <br />02/22/2018 <br />EACH OCCURRENCE <br />$ 4,000,000 <br />X <br />! $ 4,000,000 <br />EXCESS LIAR <br />CLAIMS�MAOE <br />DIED I X I RETENTIONS none <br />_AGGREGATE <br />Is <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANYPRORIETORIATNEWE <br />OFFICERIMEMBER EX LUDEDJ(ECUTIVE <br />DFr3CERIMEMBER EXCLlJDED7 Y <br />(Mandatory In NH) <br />NIA <br />PRWC836165 <br />- <br />04103120'170410312018 <br />X I STATUTE ERH <br />000 0_00 <br />5 1, y <br />$ 1,000,000 <br />E.L. EACH ACCIDENT <br />EL. DISEASE - EA EMPLOYEE <br />describe under <br />DESC PT ON OF OPERATIONS below <br />_ <br />E.L. DISEASE - POLICY LIMIT <br />$ 1,000,000 <br />Tools and Equipment <br />Installation Floater <br />$75,000. Limit <br />A <br />Commercial Inland Marine <br />ACP CIM 2292994383 <br />02122120170212212018 <br />Contractors Equip <br />$22,250. Limit <br />All .lab Sites of the Insured <br />$500.1141000. Ded I <br />Respectively <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requdredl <br />Orange County is included as additional insured and Waiver of Subrogation applies per Blanket Contractors Enhancement <br />Endorsement CG 72 88 under the general liability policy (please refer to attachments). The Umbrella /Excess Liability policy is "fallow <br />farm ". Blanket Waiver of Subrogation also applies to the workers compensation policy (please refer to attachments). <br />CERTIFICATE HOLDER CANCELLATION <br />Orange County <br />P. O. Box 8181 <br />Hillsborough, NC 27278 <br />E -Mail: tcomar @orangecountync.gov <br />E -Mail: anitaj @pronetsystemsnc.com <br />E -Mail: patf@pronetsystemsnc.com <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION HATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHO55.ED REPR�ENTAJJVE <br />yf f J •Y f y f. -. <br />lw "a uoo -ztj I a HL.IJrSLi M1, IJf[a-'umm I iviv. HII rlgins reserveo. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACCIRD <br />