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DocuSign Envelope ID: 23DO0540- 4B67- 4A91- B622- 510CAEF24EEE <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATEIM:OrYYnI <br />6 511 612 01 8 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br />CERTIFICATE [TOES 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 doe8 not confer rights to the certificate holder In lieu of such endorsement(s). <br />PRODUCER <br />CONTACT Diane Nadeau <br />'AM, <br />_ <br />PHON o {9t9) 858.4511 k9 : (919) 968 8991 <br />Business Insurers of Carolinas <br />E-MAIL dnadealr[�6usiness- insurers.com <br />ADDRESS: <br />806 Eastowne Drive, Suite 268 <br />INSURERS APFORDING COVLRAGE <br />NAIL t <br />PO Box 2538 <br />INSURERA: American Liberty Insurance Co <br />25186 <br />Chapel Hill NC 27515 -2536 <br />INSURED <br />INSURER B: Employers Mutual Casualty <br />21415 <br />INSURER C: <br />DISPUTE SETTLEMENT CENTER IMC <br />IN5U RER D : <br />_ <br />302 W WEAVER ST 51-L A <br />INSURER E; <br />$ 300,000 <br />INSURER F: <br />S 5,000 <br />CARRBORO NC 27516 -6904 <br />rc ®—le ATC 1,11 lsaaCV• CLI951622265 riFVL4`iew wwRr -R. <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. NIC nMTHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAYBE 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 />TYPE0FINSLIRANCE <br />INSDL <br />wun. <br />POLICY NU MBER <br />FULIL; E <br />POI D1YExv <br />_ <br />LIMITS <br />- <br />X <br />COMMERCIAL GENERALLIAE01 -rN <br />EACH OCCURRENCE <br />$ 1,009,000 <br />� <br />CLAIMS -MADE L J cccVR <br />D <br />PREIMISES f Ea . cz4t, ' e .- <br />$ 300,000 <br />MED EXP (Any ono parmn) <br />S 5,000 <br />A <br />4WS"87 <br />0611712418 <br />06117/2418 <br />PERSONAL &ADV INJURY <br />S <br />3EN 'L AGGREGATE L PUT APPLIES PER; <br />GF NF RAI AGGREGATE <br />$ 2.060,000 <br />PRODUCTS- COMPICIPADG <br />8 2,000,000 <br />F] FRO- <br />POLICY PRO- LOC <br />OTHER. <br />Hired /borrowed <br />S 1,600,900 <br />AUTOMOSILELIABILITY <br />Co <br />(1 1 WEDSINGLELIMrr <br />$ <br />U00ILY INJURY (PEr I%mW <br />$ <br />ANY AUTO <br />BODILY INJURY (Per a IdEnt) <br />; <br />OWNED SCHEDU LED <br />AUTOS ONLY AUTOS <br />HIRED NON•OWNED <br />AUTOS ONLY AUTOS ONLY <br />- <br />PROPERTY DAMAGE <br />P o r acedentl <br />$. <br />S <br />HOLAWS-MADE <br />OCCUR <br />EACH OCCURRENCE <br />$ <br />4UMBRELLALIAB <br />AGGREGATE <br />S <br />EXCESS LIAa <br />DEF) I RETENTION $ <br />$ <br />8 <br />WQRXFRS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIlI <br />ANY PROPRIETORIPA RTNER/6XF CUTIVE ❑ <br />OFFICERIMEMSHX EXCLUDED? <br />(Man datary In NH) <br />N f A <br />4H84487 <br />0611712018 <br />06/17/2019 <br />PER OTM <br />STATUTE IER <br />E.L. EACH ACCIDENT <br />g 100,449 <br />E.L. DISEASE - EA EMPLOYEE <br />S 100,000 <br />E.L. DISEASE - POLICY LIMIT <br />S 500.000 <br />If yyes, describe under <br />DESCRPT3ONOF OPrRATIONS Galaw <br />DESCRIPTION OF OPERAfIONSI LOCATIONS VEHICLES iALORD 901, Addl(lonal Remarks Schedule, may bo attached if mom space is required) <br />Orange County Government <br />PO Box 8181 <br />Hillsborough <br />ACORD 25 (2016103) <br />VHI�, <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 REPRESFNTATIVE <br />INC 27278 <br />V I'"001•LU 10 f k LJKU L1JK!'4lE[Ii] IVIY. fill rlalllu rG3GIYCU. <br />The ACORD name and logo are registered marks of ACORD <br />