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DocuSign Envelope ID:C302C384-OB14-4914-9651-159FB26527CF A 'tachment B
<br /> A Rn0 CERTIFICATE OF LIABILITY INSURANCE DAT2/(14/2019 )
<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
<br /> NAME: Maria Wilson
<br /> NFP Corporate Services (SE), Inc. PHONE FAX
<br /> 1901 Roxborough Rd, Ste 300 A/C No Ext: 704-973-2351 A/c No),
<br /> Charlotte NC 28211 ADDRESS; maria.wilson@nfp.com
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA:Allied World Specialty Insurance Company 16624
<br /> INSURED TOWENGP INSURER B:Allied World National Assurance Company 10690
<br /> TEP OpCo LLC, Tower Engineering Professionals Inc.TEP Holdings, LLC INsuRERc: Redwood Fire and Casualty Insurance Company 11673
<br /> 326 Tryon Road INSURER D:Continental Divide Insurance Company 35939
<br /> Raleigh NC 27603-3530 INSURERE: National Union Fire Insurance Company of Pittsburg19445
<br /> INSURERF: Lexington Insurance Company 19437
<br /> COVERAGES CERTIFICATE NUMBER:1751010688 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 EFF POLICY EXP LIMITS
<br /> LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDIYYYY
<br /> B X COMMERCIAL GENERAL LIABILITY 03101426 5/22/2018 5/22/2019 EACH OCCURRENCE $1,000,000
<br /> CLAIMS-MADE OCCUR DAMAGE TO RENTED
<br /> PREMISES Ea occurrence $100,000
<br /> X BI/PD Ded 25,000 MED EXP(Any one person) $5,000
<br /> PERSONAL&ADV INJURY $1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
<br /> POLICY L jE LOC PRODUCTS-COMP/OP AGG $2,000,000
<br /> OTHER: $
<br /> A AUTOMOBILE LIABILITY 6000-0379 5/22/2018 5/22/2019 COMBINED SINGLE LIMIT $1,000,000
<br /> Ea accident
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> X HIRED �( NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Per accident
<br /> $
<br /> A X UMBRELLA LIAB X OCCUR 0310-1434 5/22/2018 5/22/2019 EACH OCCURRENCE $10,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED X RETENTION$In nnn $
<br /> C WORKERS COMPENSATION TEWC913240(AOS) 5/22/2018 5/22/2019 X STATUTE ERH
<br /> AND EMPLOYERS'LIABILITY Y/N
<br /> ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000
<br /> OFFICER/MEMBER EXCLUDED? N N/A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000
<br /> D Workers Compensation TEWC913241 (FL/OR) 5/22/2018 5/22/2019 1,000,000
<br /> E Pollution Liability CP022112259 5/22/2018 5/22/2019 25,000 Deductible 5,000,000
<br /> F Professional Liability 031710965 2/9/2018 5/22/2019 200,000 Retention 5,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange County Government ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> PO Box 8181
<br /> 200 S Cameron Street AUTHORIZED REPRESENTATIVE
<br /> Attn: Risk Management
<br /> Hillsborough NC 27278
<br /> ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
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