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DocuSign Envelope ID:C5CC0858-ED80-4C68-809F-7B6563044C72
<br /> OP 11);DL
<br /> ,� ►ro, CERTIFICATE OF LIABILITY INSURANCE vATEIMMI°°rYYYY)
<br /> 1211712018
<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(les)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 tWs certificate does not confer rights to the
<br /> certificate holder in Ileu of such endorsements.
<br /> PRODUCER CONTACT Kirk Brown
<br /> Diversified Insurance NAME:PHonrE 9'19-471-S222 �Fax�
<br /> Solutions LLC ac,- ❑ EIIt: __Ltruc No:911 g-477-tiB07
<br /> P.O.Box 15734 nn�A ss:kbrownAa diverseins,aom
<br /> Durham,NC 27704- 5R055CER ' ` —
<br /> Diane S.Long cusTow ID o-F3RaW�RC —
<br /> __ INSURERS)AFFORUNJG COVERAGE NAIL 0 ,
<br /> INSURED Brown Brothers Plumbing and INSURER A:BUIlderSPreMier Insurance Co. 10844
<br /> Heating Company,fnc. INsuRESH.Builders Mutual Insurance Co. 10844
<br /> 2820 N.Roxboro Road INsuRrRc.Admiral Insurance Co. fM~ _— 44318
<br /> Durham, NC 27704 INSURER°:Travelers PraPertylCasualt ram, 36161
<br /> trlsuReR E
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 13ELOW 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 /> I�SR TYPE OF INSURANCE A POLICY NUMBER MOO D�DIYY7 M MDIYYxP LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE s 1,000,00
<br /> A X COMMERCIAL GENERAL LUABfLrrY PCP000005510 1713112018 12131/2415 A MLSjSLEaoccurnnca] $ 300,40
<br /> CLAIMS-MADEL�J OCCUR MED EXP(Anywl❑Persm S_ 10,00
<br /> X contractualliab. PERSONAL&ADV INJURY $ 1,000100
<br /> X Deductible$500. _ GENERAL AGGREGATE $ 2,000,001
<br /> GENT AGGREGATE LIMIT APPLIES PER; PRODUCTS-cOALP10A Ac $ 2,0100,00
<br /> POLICY JC PRO LQC $
<br /> AUTOMOBILE LIAUILITY COMBINED SINGLE LIMIT ,$ 1,ODD,00
<br /> A .}C-ANY Aura PCA0006942 08 1213112018 12131/2019 BODILY INJURY
<br /> BODILY INJURY(Per person) $
<br /> X ALL OWNED AUTOS SODILY INJURY(s,er aocf7enll S
<br /> SCHEDULED AUTOS PROPERTY DAMAGE &
<br /> X'MREO AUTOS tPER AINEel
<br /> X NON-OWNED AUTOS $•
<br /> )[ Deductible -0- s
<br /> X UMBRELLA LIAS X OCCUR EACH OCCURRENCE _ $ S,000,00
<br /> EXCESS LIA8 � IMS-MADE AGGREGATE $ 5,000,00
<br /> B — ���•�44 MUB0004309 01 1213112018 '1213112019
<br /> DEOUCTIBLE S
<br /> X RETENTION s 10,000
<br /> WORKERS COMPENSATION X 15S ATU- OTII-
<br /> AND EMPLOYERS'Ll"lUTY
<br /> 6 YIN
<br /> ANY PROPRIETORPARTNEREXEC TIVE U CP0044355 10 12131=18 12/31/2019 I E.L.FACHACCIDENT $ 1,OOOrflO
<br /> ❑FFll:ERIMEMBER EJ(CLl3DEOT Iy f A
<br /> ;Mandatory In NNj EL DISEASE-EA EMPLOYE $ lJ 1,00ti,00
<br /> IDE4C dt TION OF OPERATIi7N5 6vlox' E-L.DISEASE-POLICY LIMIT $ 1,000,00
<br /> C Paliution Llab. FEI-ECC-22S03 02 08/03/2018 08103/4019 OcelAggr. 2,000,00
<br /> D Thlyd Party Crime 106446766 01/20/2013 011201,2020 100,000 6000•ded.
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(Attach ACOR❑101,AddhIonal Remarks Schedule,it more space Is required)
<br /> email to,acooper@orangecountync,gov
<br /> I
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANCO7
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCFIIED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> P.O. Box 8181
<br /> Hillsborough,NC 27278 AUTILORIZEDREPRESENTATIVE T
<br /> Diane S.Long
<br /> d 1988.2009 ACORD CORPORATION. All rights reserved. I
<br /> ACORD 25(2009(09) The ACORD name and logo are registered marks of ACORD
<br />
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