2019-247-E DEAPR - Carolina Green West 10 spring renovation

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DocuSign Envelope ID:74F90525-OA41-4746-B7F1-101944939562 CAROGREr01 JCLARK '�Ct1�r2on CERTIFICATE OF LIABILITY INSURANCE DATE 4/912 DfYYYY) /9/2019 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 I BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED 1 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER CO CT Cope Little Insurance PHHCOIJ�Ex1:{98Q 406-59$8 Fu,Ne)t(704 943.0692 14045 Ballantyne Corporate Place Suite 375 1 S.customerservice@lclirm.com Charlotte,NC 28277 INSURERS AFFORDING COVERAGE NAIL p INSURER A:Builders Mutual Ins Co 10844 INSURED INSURER B:Builders Premier Insurance Company 13036 Carolina Green Corporation INSURER C: II 10108 Indian Trail Fairview Rd INSURER D: f Indian Trall,NC 28079 — { INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REV SION 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRA X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 1,000,000 CLAIMS-MADE ]OCCUR tiPP8072114 '10/1/2018 10/1/2019 DAMAGE TO RENTED 500,000 MED EXP(Any one emon 5,00D PERSONAL&ADV INJURY 1,000,000 GEN'L AGGREGATE UMITAPPLIES PER: GENERAL AGGREGATE 2,0❑0,000 POLICY zn-, WC PRODUCTS-COMPIOPAGG 2,000,000 OTHER: PESTICIDE 1,000,000 13 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 x ANY AUTO PCA0016868 10/1/2018 101112019 BODILY INJURY Per arson OWNED ONLY �AUTOSULED BODILY INJURY Per accident $ X AkJTO$ONLY x AUTOS ONL� PeOraoddenl MApE x ComvlCNI Ded, A x 5U1MBB3RELLALIAS x OCCUR 5,000,0010 EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE MU130003317 10/1/2018 10/1/2019 AGGREGATE $ 5,000,000 DED I X I RETENTION$ 10,000 A WORXERS GDMPENSATION xPER OTFI AND EMPLOYERS'LIABILITY ANY PROPWETORIPARTNER1EXECDT1VE YIN WCP1042087 101112018 10/112019 500,000 OFFICE RMA MBE EXCLUDED? � NIA E.L EACH ACCIDENT (MandagrMY9U NH] E.L.DISEASE-EA EMPLOY 5fl0'0fl0 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT A LeasedlRented CPP0072114 101112018 10/112019 Limit 200,000 A Equipment Floater CPP0072114 10/1/2018 10/1/2019 Limit 3,458,554 DESCRIPTION OF OPERATIONS f LOCATIONS f VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If mare space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count Dept.of Environment,Agriculture,Parks& THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 y p g ACCORDANCE WITH THE POLICY PROVISIONS. Recreation 4710 West Ten Road Efland,NC 27243 AUTHORI2ED REPRESENTATIVE ACORD 25(2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and Toga are registered marks of ACORD