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DocuSign Envelope ID: 04E136D1 -507C- 4219- BF16- 446F8D2192F8
<br />BORDCON -02 MAIRINGTON
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />ACORD 25 (2016103) © 1988 -2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />DATE 04 /17 /201 YY)
<br />0411712018
<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 INSUREII 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 does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT Melanie A. Airington
<br />NAME:
<br />(Alc,NN , Ext): (919) 469 -2473 (.vc, No):(919) 4674987
<br />TriSure Corporation - HS
<br />4325 Lake Boone Trail, Suite 200
<br />Raleigh, NC 27607
<br />E-MAIL SS: mairington @trisure.com
<br />INSURERS) AFFORDING COVERAGE
<br />NAIL #
<br />INSURERA : Phoenix Insurance Company The
<br />25623
<br />INSURED
<br />INSURER B : Travelers Property Casualty Company of America
<br />25674
<br />Bordeaux Construction Company, Inc.
<br />INSURER C : Travelers Casualty Insurance Company of Americ
<br />19046
<br />#101
<br />135 E Martin St
<br />INSURERD : Tokio Marine Specialty
<br />23850
<br />INSURERE : Hanover American Ins Co
<br />36064
<br />Raleigh, NC 27601
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOTHE 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 />ADDL
<br />INSD
<br />SUBR
<br />WVD
<br />POLICY NUMBER
<br />POLICY EFF
<br />MMIDDNYYY
<br />POLICY EXP
<br />MMIDDNYYY
<br />LIMITS
<br />A
<br />X
<br />COMMERCIAL GENERAL LIABILITY
<br />CLAIMS -MADE X OCCUR
<br />X
<br />DTCO2F979366PHX17
<br />12/31/2017
<br />12/31/2018
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TO RENTED
<br />PREMISES Ea occurrence
<br />300,000
<br />$
<br />_7
<br />MED EXP (Any one person)
<br />$ 10,000
<br />PERSONAL &ADV INJURY
<br />$ 1,000,000
<br />GEN'L
<br />AGGREGATE LIMITAPPLIES PEP _
<br />GENERAL AGGREGATE
<br />$ 2,000,000
<br />POLICY T JECT M LOC
<br />PRODUCTS - COMPIOPAGO
<br />$ 2,000,000
<br />Employee Bene
<br />$ 1,000,000
<br />OTHER
<br />B
<br />AUTOMOBILE
<br />LIABILITY
<br />COMBINED SINGLE LIMIT
<br />Ea accident
<br />1,000,000
<br />$
<br />X
<br />BODILY INJURY (per person)
<br />$
<br />ANY AUTO
<br />DT8102F979366TIL17
<br />12/31/2017
<br />12/31/2018
<br />BODILY INJURY Peraccident
<br />$
<br />OVNVED X SCHEDULED
<br />AUTOS ONLY AUTOS
<br />X
<br />PROPERTY DAMAGE.
<br />(Peraccident)
<br />$
<br />HIRED X NON-OWNED
<br />AUTOS ONLY AUTOS ONLY
<br />Comp $500 X Coll $500
<br />X
<br />B
<br />X
<br />UMBRELLALIAB
<br />X
<br />OCCUR
<br />EACH OCCURRENCE
<br />$ 10,000,000
<br />AGGREGATE
<br />$ 110001000
<br />EXCESS
<br />CLAIMS -MADE
<br />CUP4K009166
<br />12/31/2017
<br />12/31/2018
<br />D I X I RETENTION $ 10,000
<br />$
<br />C
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />YIN
<br />ANY PROPRIMBRf RfEXECUTIVE
<br />OFFICERfMEMBER EXCLUDED?
<br />(Mandatory inI
<br />NfA
<br />U B8J493303
<br />12/31/2017
<br />12131!2018
<br />X PER OTH-
<br />STATUTE ER
<br />EL EACH ACCIDENT
<br />1,000,000
<br />$
<br />E.L. DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />E.L. DISEASE- POLICY LIMIT
<br />1,000,000
<br />$
<br />D
<br />Profession Pollution
<br />PPK1791615
<br />03/12/2018
<br />03/12/2019
<br />Limit
<br />5,000,000
<br />E
<br />Builders Risk -MR
<br />IH6A501061
<br />12/31/2017
<br />12/31/2018
<br />Limit
<br />15,000,000
<br />DESCRIPTION OF OPERATIONS ! LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />Leased/Rented Equipment QT6607F242185COF17 (The Charter Oak Fire Insurance Co.) NAIC #25615 12/31117- 12131/18 Leased/Rented Equipment Limit
<br />$150,000
<br />Operations of the Named Insured covered by the above referenced policies.
<br />Orange County is listed as additonal insured with respect to General Liability.
<br />CERTIFICATE HOLDER CANCELLATION
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />Orange Count
<br />9 y
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />PO BOX 8181
<br />Hillsborough, NC 27278
<br />AUTHORIZED REPRESENTATIVE
<br />ACORD 25 (2016103) © 1988 -2015 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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