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DocuSign Envelope ID:75DE7265-DAF3-4484-873B-40098EEOBD26
<br /> DATE(MMIODIYYYY)
<br /> ACC>R" CERTIFICATE OF LIABILITY INSURANCE
<br /> rte- 04i2012018
<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 INSURERS), 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 CONTACT
<br /> MARSH USA INC. NAME'
<br /> PHaNE FAX
<br /> 20 CHURCH STREET
<br /> {AlC,No,Ex!}: (IUG No
<br /> HARTFORD,CT 461 D3 E-MAIL
<br /> ADDRESS:
<br /> INSURER(5)AFFORDING COVERAGE NAIC 4
<br /> INSURER A:Harttord Fire Insurance Company _ 19682
<br /> INSURED INSURER b Mational Union Fire Insurance Company of Pittsburgh,PA 19445
<br /> OTIS ELEVATOR COMPANY
<br /> ONE FARM SPRINGS ROAD INSURER C-American Home Assurance Company 19380
<br /> FARMINGTON,CT 06032
<br /> INSURER D.New Hampshire Insurance Company 23841
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER:BTGCEZHT 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 TYPE 6F INSURANCE D L S BR POLICY`EFF POLICY EXP LIMITS LTR 0,18D WVO POLICY NUMBER MMIDDIYYYY MMIDDIYY
<br /> A X COMMERCIAL GENERAL LIABILITY G2CSET10004 04/0112018 0410112019 EACH OCCURRENCE $ 1.000,ODO
<br /> CLAIMS-MADE 1 • I OCCUR $2,004,000 general aggregate per PREMISES Ea oocurrenc& 5 340,000
<br /> focaltonlprofect
<br /> $10,000,0000 policy general aggregate MED EXP(Any one person)_ $ 10,000
<br /> PERSONAL&ADV INJURY S 1,0001000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY X PRO- LOC PRODUCTS-COMPIOPAGG S
<br /> JECT
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY 02C SET 10000{AID} 04101/2018 04/41/2019 COMBINED SING"LIMIT
<br /> 02CSET10019{HI} F,accldent 1,4DO,OOD
<br /> }( ANY AUTO Hartford Underwriters Ins BODILY INJURY(Per person) S
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY (Peragddenl)
<br /> $
<br /> A UMBRELLA LIAS X OccU 2HUT10021 04/0112418 44/4112019 EACH OCCURRENCE $ 10,000,440
<br /> EXCESS LIAR CLAIMS R-MADE AGGREGATE $ 10,000,400
<br /> DED RETENTION$ $
<br /> B WORKERS COMPENSATION CT WCiSIR 2.5h7MjEX CON- O41{711;?018 0410112019 rX PER IN-
<br /> C AND EMPLOYERS"LIABILITY 658304{1 MUTE- E
<br /> D ANY PROPRIETORfPARTNER EXECUTIVE YIN N CA-015519205 E.L.EACH ACCIDENT S 1,000,000
<br /> OFFICERIMEMBER EXCLUDED? FIN] NIA FL-015519246,MA-015519212 -- - -
<br /> (Mandatory InNH) MN-015519208,MULTI-015519204 E-L-OIsEAsE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under MULTWI5519207,MULTI- 1,040,000
<br /> DESCRIPTION OF OPERATIONS betmv 015519211 E.L.DISEASE-POLICY LIMIT $
<br /> S
<br /> S
<br /> $
<br /> i 5
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(ACORD 191,Additional Remarks Schedule,may be attached If more space Is required)
<br /> This certificate only applies 10 100 E KING ST,300 W TRYON ST-HUMAN SVC,106 E MARGARET LANE,125 COURT ST,COUNTY JAIL,510 MEADOWLANDS
<br /> DRIVE,106 E MARGARET LANE,2551 HOMESTEAD ROAD,COURT AND KING STREETS,301 W TRYON STREET,200 S CAMERON STREET,106 NASH&
<br /> KOLLOCK ST
<br /> TRD08016A,
<br /> TRD08016Z
<br /> CERTIFICATE HOLDER CANCELLATION
<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 /> Orange County AUTHORIZED REPRESENTATIVE
<br /> PO Box ugh, 7)y �
<br /> Hillsborough,NC 27278 1"/J I
<br /> Page 1 of 1 Q 1988.2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
<br />
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