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DocuSign Envelope ID:67496B91-FCOD-4188-A6C5-F7496722386E
<br /> FEDEENG-01 MSANDY
<br /> ACQ► a CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
<br /> 10/5/2016
<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 CONTACT Certificate Department
<br /> NAME:
<br /> Preferred Insurance Services,Inc PHONE FAX
<br /> 4035 Ridge Top Road,Suite 150 (A/C,No,Ext):(703)667-5940 (A/C,No):(703)991-4838
<br /> Fairfax,VA 22030 ADDRIESS:certs@preferins.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> _ INSURER A:National Fire Insurance Company of Hartford 20478
<br /> INSURED INSURER B:Valley Forge Insurance 20508
<br /> Federal Engineering, Inc. INSURER C:Continental Casualty Company 20443
<br /> 10600 Arrowhead Drive#160 INSURER D:National Fire Insurance Company
<br /> Fairfax,VA 22030
<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 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 OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM/DD/YYYY MM/DD
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR 6012243370 07/01/2016 07/0112017 DAMAGE TO RENTED 500,000
<br /> X PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY JECOT- LOC PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> OTHER:
<br /> B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> X ANY AUTO 6012197507 07/01/2016 07/01/2017 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PerOaccitlenDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY
<br /> C X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3,000,000
<br /> EXCESS LIAB CLAIMS-MADE X X 6012243529 07/01/2016 07/01/2017 AGGREGATE $ 3,000,000
<br /> DED X RETENTION$ 10,000
<br /> C WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> 6012243515 07/01/2016 07/01/2017 1,000,000
<br /> ANY PROPRIMBER/PXCLUDE/EXECUTIVE N/A X E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT
<br /> D Technology E&O 6012243370 07/01/2016 07/01/2017 Per Claim/Agg 4,000,000
<br /> D Technology E&O 6012243370 07/01/2016 07/01/2017 Deductible 25,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Re: Orange County,200 South Cameron Street,PO Box 8181,Hillsborough,NC 27278 its officers,official agents and employees are Additional Insured with
<br /> respect to General Liability regarding all work performed by the named insured. Waiver of Subrogation in favor of Additional Insureds applies to Workers'
<br /> Compensation. Umbrella Liability Follows form. 30 Days Cancellation.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange Count Emergency Services THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> g y g y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Attn: Dinah L.Jeffries,Director
<br /> 510 Meadowlands Drive
<br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE
<br /> Ai�,
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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