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DocuSign Envelope ID: E504FA6A-OE5D-49F2-8F1B-890606623980
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<br /> CERTIFICATE OF LIABILITY INSURANCE 0611812018
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIRHTS UPON THE CERTIFICATE HOLDER.THIS
<br /> CERTIFICATE DOZES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED 13Y THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF tNSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THIS iSSUINO INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER,
<br /> IMPORTANT- If the Cer6ficats holder Is an ADDITIONAL INSURED,the poilcy(les)most have ADDITIONAL INSURED provisions or ue endorsed,
<br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies"nay require an andomament. A statement on
<br /> this Certificate does not confer rights to the certificate holder in Ilau of such andoraarrlent(s).
<br /> PRODUCER NTA
<br /> NA E. Amy H.Paschat
<br /> Ken S.Larvsarl,Jr. PHONE 519.846.2090 ext 106 _._
<br /> �'` o,Ex"};�.._ 'ra• 918.846-243$
<br /> Lawson Insurance Group,Inc. A 8mly.p0$0ha(@Iawsonlns,com
<br /> 6512-101 Six Forks Rd. IrisyF�Rts�arraRnPrrocovFRna "IAICir
<br /> Raleigh,NC 27615 T_--- INSURER Nat€onw�de Nitrtuai Ittsclrance CoInlSlttty ,23787
<br /> INSURED -_ Ituuptft a: NorGUAIRD Insurance Company �26B44
<br /> ProNet Systems,Inc, IN�IxC �
<br /> 3200 Glen Royal Road INBURER0t ---
<br /> Suite 107
<br /> swsuROR e
<br /> Raleigh,INC 27617 rrsvRSre _.-��
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER;
<br /> THIS IS TO GERTiFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED. NOTWITH5TANDING ANY RECRAREMENT,TERM OR CONOMON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT To WHICH THIS
<br /> CERTIFICATE MAY or ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES Dr-SCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS.SHOWN MAY HAVE BEEN REDUCED 13Y PAID CLAIh15.
<br /> INSR AQ�LTS &. _--- .
<br /> TR TYPE ON I PQ4ICY NUNgER _ M..tt �. P ll E Y E L1MSffa •.
<br /> i x COMMERCIAL 01NEAALLIASILITY y ACP 2 202894383 02122120180212212019 EACH6C4URREr40E s 1,000,000
<br /> A CLAIMS-MADE t^1 OCCUR �wo"o-a c —
<br /> P ull s c rar s•100,000
<br /> ]( Contractual Uability MEDEXalann 6,000 _
<br /> Contractor's Enhancement r-ERSONALGADJINJURY s 1,000,000
<br /> I GEN'LAGGREGATEUMIT APPLIES PER: GENERALAOGFEwrs s 2,000,000
<br /> }C PoucY L^1� r Loo PROucrs co.+.Pakoo s 2,OGD,O10
<br /> OTU s
<br /> AUTd1Il0YILBLVlBEIJ"'/ hA ItCUQ41 f ILE 11. i
<br /> ANY AUTO
<br /> 9WLYINJURY ftperwn) {
<br /> OLEO SC19ECULEO
<br /> 14ITa96NLY RUTOS aODILY INJURY{P�atetpftpbnl}
<br /> AUTOS ONLY
<br /> f
<br /> X ILIMOR UALIA5 ILI OCCUR Y ACP 2202984363 0212212078 0212212019_EAcuoccuRncrx€ 5 4,000,00
<br /> A X EXCESS LIDS CLNMS-WADE AGGREGATE s 4,000,004
<br /> O X I RET ENT I Ns Nun& s
<br /> Yr47RKERSCOMPE,NSATION y PRWC838166 - 0410312018 04/0212015]( s°. T �rr•
<br /> AND O MPLOYERs"LLARIIJTY ���.
<br /> Ah'YPAOPMETORJPARrHEW.XKUTIVE YEN EN5 IDEIII _FICF"A9fABLRLXCLUDEO? ® NIA $1,OOEi,001}{INigll'ryNv EA EMPLOYE s 1,000,000 99 Cesactte rxldas$( IPTION �OPERAT104SbN" POLICY b 1,0{10,000 Taois#nd Equipment on Floater 75,000,Limit
<br /> A Commercial Inland Marine ACP 2202994383 07122120180212212019 ors Equip- 22,260,Limit
<br /> All Job Sikes of the Insured 00,Ded r pect)vely
<br /> Da80RI TION OP OPERATIONS I1.00AT"ON81 VOICLIS tACORD 101,Addt0malRlr urki Inhedlels,may N ahaohed If MOO apace is mqurredj
<br /> Orange County is included as additional insured and waiver of subrogatlon applies per Blanket Contractors Enhancement
<br /> Endorsement CG 72$a underthe general liability policy(please refer to attachments). The uMbrellalexcess liability policy is"fallow
<br /> form", Blanketwaiverof subrogation also applies to the workers compensation policy(see atlached).
<br /> CERTIFICATE HOLDER CANCELLATIO14
<br /> Orange County
<br /> P.0.Box alai SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLER BEFORE
<br /> iliilaboratlgh,NC 2727$ THE EXPIRATION DATE THEREOF, NOTICE WALL 69 DELIVERED 114
<br /> ACCORDANCE NIETHTHE POLICY PROVISIONS,
<br /> i
<br /> Email_ abames @orangecountync.gov Avnsor x oREPR sNTAT E
<br /> Email: anitaj @pronetsystemsnc.com /
<br /> r
<br /> I t~mrtll: patfabprnnntsystemsno,com '�.'•,�+�-,�'%rr r�:LC:��,�y„,,(�
<br /> (01988.2015 ACORD CORPORATiON. Ali rights reserved.
<br /> ACORD 26{2018103) The ACORD name and logo are registered marks of ACORD
<br />
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