2019-231-E Planning - Transstate LLC Efland Sewer Repairs

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DocuSign Envelope ID:8BEB6A42-094D-454B-878B-4C7142FFC9A3 TRANLLC-03 SONIARODERICK '4�aRo CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 14- � 03/27/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND 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 INSURER(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 SUBROGATION 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 Leslie Tyler NFP Property&Casualty Services, Inc. PHONE FAX 19510 Jetton Rd (A/C,No,Ext):(910)794-6105 (A/C,No):(910)794-6101 Cornelius, NC 28031 E-MAIL SS:leslie.tyler@nfp.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Auto-Owners Insurance Company 18988 INSURED INSURER B:Owners Insurance Company 32700 Transstate LLC INSURER C:Carolina Casualty Insurance Company 10510 PO Box 545 INSURER D: Denver, NC 28037 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR IN SD WVD MM DD MM DD A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE FNF X OCCUR 35853599 08/28/2018 08/28/2019 DAMAGE TO RENTED 300,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY PECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: B AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ X ANY AUTO 5085359900 08/28/2018 08/28/2019 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PerOaccitlenDAMAGE $ AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE 5085359901 08/28/2018 08/28/2019 AGGREGATE $ 1,000,000 DED X RETENTION$ 10,000 C WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER BNUWC0137911 08/28/2018 08/28/2019 1,000,000 OFFICERO/MEMBER EXCLUDEDXECUTIVE ❑ N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Certificate Holder is additional insured with regards to general liability when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Planning and Inspections Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g Y 9 p p ACCORDANCE WITH THE POLICY PROVISIONS. ATTN:Christopher Sandt,Staff Engineer 131 W.Margaret Lane PO Box 8181 AUTHORIZED REPRESENTATIVE Hillsborough, NC 27278 Fr4e ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD