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DocuSign Envelope ID: B6D50041- 4029- 45D2- A904- A005EF2DD654 <br />'ACaRL7� CERTIFICATE OF LIABILITY INSURANCE <br />PDA7TE(MM /DD/YYYY) <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />07/18/2018 <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(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 Crystal Ireland <br />NAME: <br />Business Insurers of Carolinas <br />PHCONNo Ext : (919) 968 -4611 FAX No): (919) 968 -8991 <br />E -MAIL cireland @business - insurers.com <br />ADDRESS: <br />800 Eastowne Drive, Suite 208 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />PO Box 2536 <br />INSURERA: Travelers Indeminity <br />25658 <br />Chapel Hill NC 27515 -2536 <br />INSURED <br />INSURER B: Phoenix <br />25623 <br />INSURER C : Travelers Property Cas Co of America <br />36161 <br />Summit Design and Engineering Services PLLC <br />INSURER D: <br />DAMAGE <br />,REM SESOEa oicc E.Dence <br />504 Meadowlands Drive <br />INSURER E: <br />MED EXP (Anv one person) <br />$ 5,000 <br />INSURER F: <br />Hillsborough NC 27278 <br />COVERAGES CERTIFICATE NUMBER: CL1832121689 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />INSD <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM /DD /YYYY <br />POLICY EXP <br />MM /DD /YYYY <br />LIMITS <br />X <br />COMMERCIAL GENERAL LIABILITY <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE OCCUR <br />DAMAGE <br />,REM SESOEa oicc E.Dence <br />$ 100,000 <br />MED EXP (Anv one person) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />A <br />Y <br />6304KO89149 <br />01/01/2018 <br />01/01/2019 <br />GEN'LAGGREGATE LIMIT APPLIES PER: <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />PRO <br />POLICY <br />POLICY � PRO ❑ LOC <br />PRODUCTS - COMP /OPAGG <br />$ 2,000,000 <br />$ <br />AUTOMOBILE <br />LIABILITY <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1,000,000 <br />X <br />BODILY INJURY (Per person) <br />$ <br />ANYAUTO <br />B <br />OWNED SCHEDULED <br />AUTOS ONLY AUTOS <br />Y <br />810- 2J958216 <br />04/02/2018 <br />04/02/2019 <br />BODILY INJURY (Per accident) <br />$ <br />X <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />HIRED �/ NON -OWNED <br />AUTOS ONLY /� AUTOS ONLY <br />Experience Mod Factor 2 <br />$ <br />X <br />UMBRELLA LIAB <br />X <br />OCCUR <br />EACH OCCURRENCE <br />$ 6,000,000 <br />AGGREGATE <br />$ 6,000,000 <br />C <br />EXCESS LIAB <br />CLAIMS -MADE <br />CUP4K264429 <br />01/01/2018 <br />01/01/2019 <br />DED I X1 RETENTION $ 10,000 <br />$ <br />B <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR /PARTNER/EXECUTIVE <br />OFFICER /MEMBER EXCLUDED? N <br />( Mandatory in NH) <br />NIA <br />UB4K258355 <br />01/01/2018 <br />01/01/2019 <br />�/ <br />X STATUTE X ORTH- <br />E.L. 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 />Excess Policy over GL, AU, WC <br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Project: Link Facility <br />Orange County is included as Additional Insured with regards to General Liability and Auto Llability policy as required by written contract. <br />CERTIFICATE HOLDER CANCELLATION <br />@ 1988 -2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />Orange County <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />200 S Cameron Street <br />AUTHORIZED REPRESENTATIVE <br />Hillsborough NC 27278,/ <br />j <br />@ 1988 -2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD <br />