2018-455-E AMS -Signarama Passmore mobility

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DocuSign Envelope ID: C64A834C- 79DE- 4CE8- BD84- E1C4F13A54F6 ACORN® AC� CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 6/28/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: AX . E., Ext: (919) 732 -2191 _[(MC, No: (919)732 -2192 Colonial Insurance Agency Hillsborough E -MAIL ADDRESS: COMMERCIAL GENERAL LIABILITY INSURER(S) AFFORDING COVERAGE NAIC # PO BOX 490 INSURERA:Owners 32700 HILLSBOROUGH NC 27278 INSURED INSURER B: CLAIMS -MADE 1X OCCUR INSURER C: Greer And Associates Inc dba Signarama INSURER D: Design Studio of Durham, DesignElement INSURER E: $ 300,000 3702 Hillsborough Rd Ste 1 INSURER F: $ 10,000 Durham NC 27705 -2953 COVERAGES CERTIFICATE NUMBER:CL1762802294 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM /DD/YYYY POLICY EXP MM /DD /YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE 1X OCCUR DAMAGE TO PREMISES Ea occuErrDence $ 300,000 MED EXP (Any one person) $ 10,000 35171729 6/30/2017 6/30/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3 , 000 , 000 POLICY PRO- ❑ LOC JECT X PRODUCTS - COMP /OP AGG $ 3 , 000 , 000 Premises /Operations $ OTHER: AUTOMOBILE LIABILITY (CEO, accidMBINED ent SINGLE LIMIT $ 1 , 000 , 000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 4925065704 6/30/2017 6/30/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE APer accident $ NON -OWNED HIRED AUTOS AUTOS Uninsured /Underinsured $ 1,000,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2 , 000 , 000 A EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 10,000 $ 4925065702 6/30/2017 6/30/2018 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER ANY PROPRIETOR /PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 A OFFICER /MEMBER EXCLUDED? (Mandatory in NH) NIA 35148890 6/30/2017 6/30/2018 E.L. DISEASE - EA EMPLOYE $ 1 , 000, 000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Job Location: 2551 Homestead Rd Chapel Hill NC 27517 Certificate holder is additional insured with respects to General Liability by signed written contract before a loss. CERTIFICATE HOLDER CANCELLATION abarnes @orangecountync.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE CARLA MOORE /CARLA��o ACORD 25 (2014/01) INR025 19ni4nn ©1988 -2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD