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2018-795-E Planning - McGill Efland Sewer Project contract amendment 2
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2018-795-E Planning - McGill Efland Sewer Project contract amendment 2
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Last modified
12/28/2018 10:15:56 AM
Creation date
12/12/2018 11:38:39 AM
Metadata
Fields
Template:
Contract
Date
12/10/2018
Contract Starting Date
6/20/2017
Contract Ending Date
12/31/2018
Contract Document Type
Contract Amendment
Amount
$2,800.00
Document Relationships
2017-305-E Planning - McGill Associates for CEI/CMT services
(Attachment)
Path:
\Board of County Commissioners\Contracts and Agreements\General Contracts and Agreements\2010's\2017
2017-356-E Planning - McGill Associates - Duke Energy Easement plat preparation
(Attachment)
Path:
\Board of County Commissioners\Contracts and Agreements\General Contracts and Agreements\2010's\2017
2019-880-E Planning - McGill Efland Sewer Project amendment 3
(Message)
Path:
\Board of County Commissioners\Contracts and Agreements\General Contracts and Agreements\2010's\2019
2019-897-E Planning - McGill Efland sewer system phase 2 contract amendment
(Message)
Path:
\Board of County Commissioners\Contracts and Agreements\General Contracts and Agreements\2010's\2019
R 2018-795 Planning - McGill Efland Sewer Project contract amendment 2
(Attachment)
Path:
\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2018
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INSRADDLSUBRLTRINSRWVD <br />DATE (MM/DD/YYYY) <br />PRODUCER CONTACTNAME: <br />FAXPHONE(A/C, No):(A/C, No, Ext): <br />E-MAILADDRESS: <br />INSURER A : <br />INSURED INSURER B : <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />POLICY NUMBER POLICY EFFPOLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY) <br />COMMERCIAL GENERAL LIABILITY <br />AUTOMOBILE LIABILITY <br />UMBRELLA LIAB <br />EXCESS LIAB <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />AUTHORIZED REPRESENTATIVE <br />INSURER(S) AFFORDING COVERAGENAIC # <br />Y / N <br />N / A <br />(Mandatory in NH) <br />ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED? <br />EACH OCCURRENCE$ <br />DAMAGE TO RENTED $PREMISES (Ea occurrence)CLAIMS-MADEOCCUR <br />MED EXP (Any one person)$ <br />PERSONAL & ADV INJURY$ <br />GENERAL AGGREGATE$GEN'L AGGREGATE LIMIT APPLIES PER: <br />PRODUCTS - COMP/OP AGG$ <br />$ <br />PRO- <br />OTHER: <br />LOCJECT <br />COMBINED SINGLE LIMIT $(Ea accident) <br />BODILY INJURY (Per person)$ANY AUTO <br />OWNEDSCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS <br />AUTOS ONLYHIRED PROPERTY DAMAGE $AUTOS ONLY (Per accident) <br />$ <br />OCCUR EACH OCCURRENCE$ <br />CLAIMS-MADE AGGREGATE$ <br />DEDRETENTION$$ <br />PEROTH-STATUTEER <br />E.L. EACH ACCIDENT$ <br />E.L. DISEASE - EA EMPLOYEE$ <br />If yes, describe under E.L. DISEASE - POLICY LIMIT$DESCRIPTION OF OPERATIONS below <br />POLICY <br />NON-OWNED <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 />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 />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 any rights to the certificate holder in lieu of such endorsement(s). <br />COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: <br />CERTIFICATE HOLDERCANCELLATION <br />© 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03) <br />ACORDTM CERTIFICATE OF LIABILITY INSURANCE <br />Pennsylvania National Mutual Cas Ins Co <br />1/22/2018 <br />BB&T Insurance Services, Inc. <br />301 College St., Ste. 208 <br />Asheville, NC 28801 <br />828 277-3930 <br />Ben Culp <br />828 277-39248888279875 <br />bculp@bbandt.com <br />McGill Associates PA <br />P.O. Box 2259 <br />Asheville, NC 28802 <br />14990 <br />AX <br />X <br />x <br />xBP9065291501/23/201801/23/20191,000,000 <br />50,000 <br />5,000 <br />1,000,000 <br />2,000,000 <br />2,000,000 <br />A <br />X <br />XX <br />xAX9065291501/23/201801/23/20191,000,000 <br />A XX <br />X10000 <br />x UL9065191501/23/201801/23/20195,000,000 <br />5,000,000 <br />Orange County is named as Additional Insured with respects all policies listed above with the exception of <br />Worker's Comp when required by written agreement with the insured. We will provide 30 days prior written <br />notice of any cancellation, non-renewal or reduction of coverage except in the event of nonpayment of <br />premium which is 10 days notice. <br />Orange County c/o Planning & <br />Inspections <br />P.O. Box 8181 <br />Hillsborough, NC 27278-0000 <br />1of 1#S19396654/M19395232 <br />30MCGILASSClient#: 1170972 <br />BDCU1of 1#S19396654/M19395232 <br />DocuSign Envelope ID: D413A6FD-3C88-4C78-BEEC-313DACA874A0
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