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DocuSign Envelope ID:7DA08667-E2B1-4977-9635-87E3B742D4AB <br /> �11 OF ID. DL <br /> p• CERTIFICATE OF LIABILITY INSURANCE DATE 1212712017 <br /> 1 YJ <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,ARID THE CERTIFICATE BOLDER, <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 pollcies may require an endorsement. A statement on this certificate does not conifer rights to the <br /> certificate holder in lieu of such endorsements. <br /> PRODUCER CONTACT <br /> Tyyson Insurance Services,Inc. HAMS; Kirk Brown <br /> 2609 N Duke St Suite 102 Ric°N o Ex .919471-$222 We Nm;918-471-fi607 <br /> P.O.Box 15734 E-MAIL <br /> Durham,NC 27704- ADDRESS:kbrown@tysoninsurance-coml <br /> Diane S.Long C <br /> PRQDU <br /> STONER CER IQ R:BROWBRO <br /> INSURER(S)AFFORDING COVERAGE _ NAIC N <br /> INSURED Brown Brothers Plumbing and INSURER A:Builders Premier Insurance Co. 10844 <br /> Heating Company INSURER B:Builders Mutual Insurance Co. 10844 <br /> 2820 N.Roxboro Road INSURER c.Admiral Insurance Co. 44318 <br /> Durham,NC 27704 <br /> INSURER D:Travelers PropertylCasuaq 36161 <br /> INSURER E: <br /> 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 NTH 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 ADDL BUD POLICY EFF POLICY EXP - <br /> LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDQ LIMITS <br /> GENERAL LIABILITY EACHOCCURRENCE S 11000100 <br /> DAMAGE TO RENTE — <br /> A X COMMERCIAL GENERAL LIABILITY PCP0000055 09 12/3112017 12/3112018 PREMISES Ea occurs nce $ 300,00 <br /> CLAIMS-MADE IXI OCCUR MED EXP(Any One Person) S 10,00 <br /> X Contractual flab. - PERSONAL&AOV INJURY S 1,000,00 <br /> X Deductible$SOO. GENERAL AGGREGATE $ 2,000,00 <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00fl <br /> POLICY X PRO-jEr'TLOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 <br /> A X ANY AUTO PCA0006942 07 12/3112017 12/3112018 (Ea amidont) <br /> BODILY INJURY(Per person) $ <br /> X ALL OWNED AUTOS UODILY INJURY(Per accfdenl) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> X HIRED AUTOS (PER ACCIDENT) $ <br /> X NON-OWNEDAUTos S <br /> X Deductible -0- r <br /> - 6 - <br /> X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 <br /> EXCESS LIA$ I <br /> B CLAIMS-MAD€ MUB0004308 00 12131120'I7 12/3112018 AGGREGATE - $ 5,000,0'0 <br /> dDEDUCTIBLE $ <br /> X RETENTION 10,000 $ <br /> WORK FRS COMPENSATION X WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY <br /> B ANYICERIMEMRFRY ETORIP7ARTNERO7ECUTIVE Y IN <br /> NrA CP004435509 12131/2017 12/31/2018 E.L.EACH ACCIDENT $ _1,000,00 <br /> (Mandatory in NMI E.L-DISEASE-EA EMPLOYEE S 11000,00 <br /> If yes desulbe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 <br /> C Pollution Liab. FEi-ECC-22903-01 08103121)17 08/0312018 Occ/Aggr. 2,000,00 <br /> D Third Parry Crime 106446766 01120/2018 01/20/2019 1100,000 5000.ded <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACORD 1e1,Additional RembrM Schedule,If mrne space Is required) <br /> email to;acooperr@orangecountync.gov <br /> i <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANC07 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange Count THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> g y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P.O.Box 8181 <br /> Hillsborough,NC 27278 AUTHDRIZEO REPR£SENTATIV <br /> Diane S.Lang <br /> 01988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009109) The ACORD name,and logo are registered marks of ACORD <br /> I <br />