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DocuSign Envelope ID:B01E86EC-6FC1-43CE-8E90-79CF68C52249
<br /> a+ucr �ry ECSCAR01
<br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE FDATE 2/26/2019(MMIDD(MM/DD/YYYY)
<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 be endorsed.If SUBROGATION IS WAIVED,subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Meg S. Lee,CIC
<br /> Andersen Insurance Group PHONEo, 703-988-0900 FAX,
<br /> Ext. 102
<br /> A/C A/C,N Ext: No
<br /> 5870 Trinity Parkway E-MAIL eanee
<br /> ADDRESS: me g@th drsnr g p•com
<br /> Suite 130 INSURER(S)AFFORDING COVERAGE NAIC#
<br /> Centreville,VA 20120 INSURER A Cincinnati Insurance Company 10677
<br /> INSURED INSURER B:Federal Insurance Company 20281
<br /> ECS Southeast, LLP INSURER C Property/Casualty Ins.Co.of Hartford 30147
<br /> 14026 Thunderbolt Place, Suite 500 INSURER D ACE American Insurance Company 22667
<br /> Chantilly,VA 20151
<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 CONTRACTOR 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 INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
<br /> A GENERAL LIABILITY X X ENP0219991 12/01/2018 12/01/2019 EACH OCCURRENCE $1 OOOOOO
<br /> X COMMERCIAL GENERAL LIABILITY PREMISES ERENTED
<br /> ccr nce $500,000
<br /> CLAIMS-MADE 4 OCCUR MED EXP(Any one person) $10,000
<br /> X Contractual Liab PERSONAL&ADV INJURY $1,000,000
<br /> X X C U GENERAL AGGREGATE $2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
<br /> POLICY X PRO LOC $
<br /> JECT
<br /> A AUTOMOBILE LIABILITY X X CPA1097785 12/01/2018 12/01/201 COEaMBINED ccidentS INGLE LIMIT $1r r OOO OOO
<br /> a
<br /> X ANY AUTO BODILY INJURY(Per person) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS Per accident
<br /> B X UMBRELLA LIAB X OCCUR X X 79891344 12/01/2018 12/01/2019 EACH OCCURRENCE s5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE s5,000,000
<br /> DED X RETENTION$O $
<br /> C WORKERS COMPENSATION X 42WNS49520 12/01/2018 12/01/2019 X WCSTATU- OTH-
<br /> AND EMPLOYERS'LIABILITYs ER
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N All States Endt 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 /> A Excess Liability X X EXS0220000 12/01/2018 12/01/2019 $10,000,000 Limit
<br /> D Pollution Liab X X CPMG28192289 12/01/2018 12/01/2019 $7,000,000 Inc/Aggr
<br /> $50,000 Retention
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required)
<br /> Project: Orange County Northern Campus, US 70 West(Cornelius Street), Hillsborough, NC
<br /> Certificate Holder is included as an Additional Insured on all policies except Worker's Compensation.A
<br /> waiver of subrogation is granted in favor of the Certificate Holder where required by written contract.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> Orange Count SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> g y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 200 S. Cameron Street ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> Hillsborough, NC 27278
<br /> AUTHORIZED REPRESENTATIVE
<br /> :y' hu�s (` `may. 'tic ; :
<br /> .�
<br /> ©1988-2010 ACORD CORPORATION.All rights reserved.
<br /> ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
<br /> #S307480/M300554 M E F
<br />
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