2019-001-E DEAPR - Blackwood Farm Park design

Browse Search

DocuSign Envelope ID: E45930OD-0094-4E66-A944-039543AOE351 ® ❑ATE(MMIDDffYYY) A`COROP CERTIFICATE OF LIABILITY INSURANCE 1 V0612018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGA7ION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Susan Erickson NAME: Carter Glass Insurance Agency PHONE EIS, (919)781-1973 AX(All No: (999)781-1974 5901 Falls of Neuse Road E-MAIL serlckscnacc-is.net ADDRESS: INSURFRI[Sl AFFORDING COVERAGE NAIC 11 Raleigh INC 27609 INSURERA: Nationwide Mutual Fire Insurance Company 23779N INSURED INSURER 8: SUSAN HATCHELL LANDSCAPE ARCHITECTURE PLLG INSURER C: 711 W NORTH ST INSURER 0: INSURER E: RALEIGH NC 276113.1418 INSURER F: COVERAGES CERTIFICATE NUMBER: 2017/18 GL&OAF Master REVISION NUMBER: THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I ADDLSUHR TYPE POLICY EFF POLICY EXP LIMITS LTR N ❑ ❑ POLICY NUMBER MWDDlYYYY MW00NYYV X COMMERCIAL GENERAL LIABILITY EACH GC CUR RE NCE $ 1,000,000 CA_7CLAIMS-MADE � OCCUR PREM SES Ea accu AGETORENTEo nca $ 300,000 MED E 9(Any one person) $ 5,000 A Y ACPBPOF2202888274 12/02/2017 12/02/2018 P ERSONAL&A DV I NJURY $ 1,000,000 GEN'L ACG RECATE LI MIT APPLIES PER: GENERALAGGREGATE $ 2,000,000 �C POLICY JEtl El LOC PRO DUCTS-COMPIOPAGG $ 2,000,000 OTHER: Hired Auto Liab $ 1.000.000 AUTOMOBILE LIABILITY INGLE LIMIT $ 1.000.000 Ea aG[Idenl ANYAUTO BCD ILYINJURY(Po rperaan) $ * OWNED SCHEDULED ACPBPOF2202888274 12/02/2017 12/02/2018 BODILYINJURY(Per aoddeno $ AUTOSONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOSONLY AUTOS ONLY 1pef a Id nt $ X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000.000 A EXCESSLIA6 HCLAIMS-MADE ACPCAF2202888274 12/02/2017 12/02/2018 1 AGGREGATE s 1,000,000 DED RETENTION$ $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRiETORIPARTNERIEXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OF F ICERJMEM BER EXCLUDED? (M andata ry In N H) E.L.DISEASE-EA EMPLOYEE $ I I yo s,dascrihe and e r DESCRIPTION 0FOPERATI0NS halaw E.L.DISEASE-POLICY LIMIT $ ❑FSCRIPTION OF OP ERATTONS I'LOCATIONS I VEHICLES{AC OR 101.Additional Remarks Schedule,may he attached I more space is requ Ired} Marabeth Carr,ASLA,orange County Is included as additional insured as per written ccntracl. Re:Blackwood Farm Park CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL.BE DELIVERED IN Marabeth Carr,ASLA ACCORDANCE WITH THE POLICY PROVISIONS. Orange County AUTHORIZE❑REPRESENTATIVE PO Box 8181 Hillsborough NO 27278 O 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD