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DocuSign Envelope ID:69AD1 F06-F34D-47CE-9E90-CAC736E68170 <br /> F�2/28/2018 <br /> E(MM/DD/YYYY) <br /> ACa1zo® CERTIFICATE OF LIABILITY INSURANCE <br /> 1/1/2019 <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 Lockton Companies NAME:CONTACT <br /> 444 W.47th Street,Suite 900 PHONE FAX <br /> Kansas City MO 64112-1906 E-MAIL <br /> tAIo Ext: A/C No <br /> (816)960-9000 ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Lexington Insurance Company 19437 <br /> INSURED TERRACON CONSULTANTS,INC. INSURER B:Travelers Property Casualty Co of America 25674 <br /> 1312893 2401 BRENTWOOD ROAD INSURER C:The Travelers Indemnity Com an 25658 <br /> RALEIGH NC 27604 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES TERCO01 CERTIFICATE NUMBER: 15244029 REVISION NUMBER: XXXXXXX <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 POLICY NUMBER MM/DDIYYYY MM/DDIYYYY <br /> B X COMMERCIAL GENERAL LIABILITY y N TC2J-GLSA-1118L293 1/1/2018 1/1/2019 EACH OCCURRENCE $ 1,000,000 <br /> A AGE To ENTED <br /> CLAIMS-MADE � OCCUR PREM MIS <br /> Ea occu ante $ 1 OOO OOO <br /> X CONTRACTUAL LIAB MED EXP(Any one person) $ 25,000 <br /> X XCU COVERAGE PERSONAL&ADV INJURY $ 1000 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY�JE� LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: $ <br /> MINED <br /> B AUTOMOBILE LIABILITY Y N TC2J-CAP-131J3858 1/1/2018 1/1/2019 Ea ac.,d.",SINGLE LIMIT $ 2,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS XXXXXXX <br /> HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ XXXXXXX <br /> UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ XXXXXXX <br /> DED RETENTION$ $ XXXXXXX <br /> WORKERS COMPENSATION PER OTH- <br /> B AND EMPLOYERS'LIABILITY N TC2JUB I 31J374218(AOS) 1/1/2018 1/1/2019 X STATUTE ER <br /> C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N TRKUB131J384618(AZ,MA,WI) 1/1/2018 1/1/2019 E.L.EACH ACCIDENT $ 1,000,000 <br /> C OFFICER/MEMBEREXCLUDED? ❑N N/A TC2JUB I 31J374218(CA) 1/1/2018 1/1/2019 <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 $ 1000 000 <br /> A PROFESSIONAL N N 26030216 1/1/2018 1/1/2019 $1,000,000 EACH CLAIM& <br /> LIABILITY $1,000,000 ANNUAL AGGREGATE <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> RE:70171288 SPORTSPLEX FIELD HOUSE TESTING.ORANGE COUNTY,NC IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY, <br /> AUTO LIABILITY AND UMBRELLA/EXCESS LIABILITY,AS REQUIRED BY WRITTEN CONTRACT. <br /> CERTIFICATE HOLDER CANCELLATION <br /> 15244029 <br /> ORANGE COUNTY,NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> P.O.BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> HILLSBOROUGH NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIV. <br /> ©1988Li015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />