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TheACORDnameandlogoareregisteredmarksofACORD <br />CERTIFICATE HOLDER <br />©1988-2014ACORDCORPORATION.Allrightsreserved. <br />ACORD25(2014/01) <br />AUTHORIZED REPRESENTATIVE <br />CANCELLATION <br />DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE <br />LOCJECTPRO-POLICY <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />OCCURCLAIMS-MADE <br />COMMERCIAL GENERAL LIABILITY <br />PREMISES(Eaoccurrence)$DAMAGE TO RENTED <br />EACHOCCURRENCE$ <br />MEDEXP(Anyoneperson)$ <br />PERSONAL&ADVINJURY$ <br />GENERAL AGGREGATE $ <br />PRODUCTS - COMP/OP AGG $ <br />$RETENTIONDED <br />CLAIMS-MADE <br />OCCUR <br />$ <br />AGGREGATE $ <br />EACHOCCURRENCE$UMBRELLA LIAB <br />EXCESS LIAB <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />INSRLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)LIMITS <br />PERSTATUTE OTH-ER <br />E.L.EACHACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />$ <br />$ <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />Ifyes,describeunder <br />DESCRIPTION OF OPERATIONS below <br />(Mandatory in NH) <br />OFFICER/MEMBER EXCLUDED? <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y / N <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />ALLOWNEDSCHEDULED <br />HIRED AUTOS NON-OWNED <br />AUTOSAUTOS <br />AUTOS <br />COMBINED SINGLE LIMIT <br />BODILYINJURY(Perperson) <br />BODILYINJURY(Peraccident) <br />PROPERTY DAMAGE $ <br />$ <br />$ <br />$ <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 />INSD <br />ADDL <br />WVD <br />SUBR <br />N / A <br />$ <br />$ <br />(Eaaccident) <br />(Peraccident) <br />OTHER: <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 be endorsed. If SUBROGATION IS WAIVED, subject to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />COVERAGESCERTIFICATENUMBER:REVISIONNUMBER: <br />INSURED <br />PHONE(A/C, No, Ext): <br />PRODUCER <br />ADDRESS:E-MAIL <br />FAX(A/C, No): <br />CONTACTNAME: <br />NAIC# <br />INSURER A : <br />INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />INSURER(S)AFFORDINGCOVERAGE <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 />INS025 (201401) <br />2/21/2018 <br />JJ Wade & Associates <br />P.O. Box 1209 <br />212 S Main St. <br />Davidson, NC 28036 <br />Harriet Thomas <br />(704)892-9297 (704)896-0485 <br />hthomas@jjwadeinsurance.com <br />The John R. McAdams Company, Inc. <br />PO Box 14005 <br />Research Triangle Park, NC 27709 <br />National Fire Insurance of Hartford20478 <br />Continental Casualty Company20443 <br />Valley Forge Insurance Company20508 <br />2017-2018 <br />A <br />X <br />X <br />X Contractual Liability <br />X No XCU Exclusion <br />X <br />X 604543900112/31/201712/31/2018 <br />1,000,000 <br />100,000 <br />15,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />A X <br />XX <br />6045439029 12/31/201712/31/2018 <br />1,000,000 <br />B <br />XX <br />X 6045439063 12/31/2017 12/31/2018 <br />5,000,000 <br />5,000,000 <br />C N <br />6045439046 12/31/2017 12/31/2018 <br />X <br />1,000,000 <br />1,000,000 <br />1,000,000 <br />Certificate Holder is included as an Additional Insured with respects to General Liability and Umbrella <br />Liability as required by written contract. <br />J.J. Wade, III/AH <br /> Orange County Planning and <br /> Inspections Department <br /> PO Box 8181 <br /> 131 W. Margaret Lane <br /> Hillsborough, NC 27278 <br />hfleming@orangecountync.go <br />DocuSign Envelope ID: 8135153B-BEF8-4B98-B340-8C3E04319A63