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DocuSign Envelope ID:440150D2-FD41-4BE9-A7A3-C63D04B87273 <br /> AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMrDDIYYYY) <br /> 06/1912018 <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 NAMEA r Amy H. Paschal <br /> Ken B.Lawson,Jr. cONExt} 919-846-2090 ext 105 !Fria- No: 919-$46-2438 <br /> Lawson Insurance Group, Inc. E-MAIL ss: amy.paschal@Iawsonins.com <br /> 6512-101 Six Forks Rd. INSURERS AFFORDING COVERAGE NAIC# <br /> Raleigh, NC 27615 INSURERA: Nationwide Mutual Insurance Company 23787 <br /> INSURED INSURERB; NOrGLIARD Insurance Company 25844 <br /> ProNet Systems,Inc. INSURERc: <br /> 3200 Glen Royal Road INSURERD: <br /> Suite 107 <br /> INSURER E: i <br /> Raleigh,NC 27617 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 l TYPE OF INSURANCE ADDL SUBR { POLICY EFF POLICY EXP <br /> LTR] POLICYNUMBER € MMIDDNYYYI (MMtDDIYYYYI 1 LIMITS <br /> �COMMERCIALGENERALUABILITY Y ACP 2202994383 02122/201802122/2019 EACH OCCURRENCE $ 1,000,000 <br /> p' 3 CLAIMS-MADE ;, I OCCUR A A N <br /> u nce $ 100,000 <br /> X Contractual Liability PREMISES Ea occrre <br /> MED EX?(Any one person) $ 5,000 <br /> FContractor's Enhancement PERSONAL&ADV INJURY S 1,000,000 <br /> GEN'LAGGREGATEUMITAPPLIESPER: Ali GENERAL AGGREGATE S 2,000,000 <br /> POLYCY II SCOT LOCI i <br /> E I PRODUCTS-COMPlOPAGG S 2,000,000 <br /> OTHER; I S <br /> AUTOMOBILE LIABILITY i COMBINED SINGLE LIMIT € <br /> Ea accident S <br /> ANY AUTO BODILY INJURY(Per person) 5 <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS I BODILY INJURY(Per accident) 5 <br /> HIRED AUTOSNON-OWNEDi I PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLYLY €1Per accident} 5 <br /> I I T 5 <br /> UMBRELL4LIA6 I OCCUR Y ACP 2202994383 j0212212018E0 212 212 0 1 9, EACFfpCcuRRENCE 5 4,000,000 <br /> A X I, EXCESS LIAB CLAIMS-MADE I AGGREGATE 5 4,000,000 <br /> DED ,X 11 RETENTIONS None <br /> ]WORKERS COMPENSATION PRWC838165 !04l0312018I)410 212 0 1 9 ]( PER OTH- <br /> l3 I AND EMPLOYERS'LIABILITY Y STATUTE ER <br /> �ANYPROPRIETORIPARTNER!EXECUTIVE YIN I 5 <br /> I.OFFICERIMEMBER EXCLUDED? Y N 1 A E,L.EACH ACCIDENT 1,000,000 <br /> (Mandatory in E.L.DISEASE-EA EMPLOYEE S 1,000 000 <br /> 4 yes,describe under € s <br /> DESCRIPTION OF OPERATIONS below I E L.DISEASE-POLICY LIMIT 5 1,000,000 <br /> Tools and Equipment j Installation Floater$75,000. Limit <br /> A Commercial Inl <br /> and Marine �ACP 2202994383 021221201$10212212019 Contractors Equip�22,250. Limit <br /> All Job Sites of the Insured $500.1$1000. Ded respectively <br /> DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required} <br /> Orange County is included as additional insured and waiver of subrogation applies per Blanket Contractors Enhancement <br /> Endorsement CG 72 88 under the general liability policy(please refer to attachments). The umbrella/excess liability policy is"follow <br /> form". Blanket waiver of subrogation also applies to the workers compensation policy(see attached). <br /> CERTIFICATE HOLDER CANCELLATION <br /> Orange County <br /> P. O.Box 8181 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Hillsborough,NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Email: abarnes@OCangecountync.gov AUTHORIZMREPRPr5ENTATIVE <br /> Email: anitaj@pronetsystemsnc.com <br /> I Email: patf@pronetsystemsnc.com <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />