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

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DocuSign Envelope ID:74F90525-OA41-4746-B7F1-101944939562 CAROGRE-01 JC LARK CERTIFICATE OF LIABILITY INSURANCE DATE(MMI019 YY) 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 he 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 endorse ment(s). PRODUCER CONTACT Cope Little Insurance HO(AICNo,Ext): 980)406-5988 AIc,Na:(704)943-0692 14045 Ballantyne Corporate Place E-MAIL Suite 375 .customerservice@lclirm.com Charlotte,NC 28277 INSURER S AFFORDING COVERAGE NAIC# INSURER A;Builders Mutual Ins Co 10844 INSURED INSURER a:Builders Premier Insurance Company 13036 Carolina Green Corporation INSURERC: Kerry Price 10108 Indian Trail Fairview Rd INSURER D: Indian Trail,NC 28079 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 AD Lit SUBINSD OR POLICY NUMBER POLICY EFF POLInNYYCY LIMITS LTRA Xl. COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 CLAIMS-MADE n OCCUR CPP0072114 1011;2018 101112019 DAMAGE TO RENTED 500,000 L&ESA MEDEXP jAnyone erson S 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY[]L�JECT LOC PRODUCTS-COMPIOPAGG S 2,000,000 OTHER: PESTICIDE S 1,000,000 B AUTOMOBILE LIABILITY CAMBI tlED SINGLE LIMIT 1,000,000 (Ea accent. X1 ANY AUTO PCAU016868 10/1/2018 101112019 BODILYINJVRY Per arson _ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accldent x AlJTaS RNLY x Al y0Q ONLY P�OPEHTY AMAGE er acold x Cn�rTgJCo11 Dad, A X 5SU1IM��BuRELLALIAB x OCCUR EACH OCCURR_OCCURRENCE 5'000�000 EXCESS I-IAB w. CLAIMS-MADE MUB0003317 10/1/2018 10/112019 AGGREGATE__ 5,000,000 DED I XC I RETENTION$ 101000 A WORKERS COMPENSATION x PER OTH- ANOEMPLOYERS'LIA Bit.ITY STATUTE 'Fs- YIN WCP1042087 10M/2018 10M12019 500,000 ANY PRO RIETgO�P�JPARTNER/E ECUTIVE N N!A E.L.EACH ACCIDENT (G.'datoryInNF[y E.L.DISEASE-£A EMPLOYEE 500,000 If yes,demAbB under 500,000 DESCRIPTION OF OPERAT ION S below E.L.DISEASE-POLICY LIMIT A Leased/Rented CPP0072114 1011/2018 10/112019 Limit 200,000 A Equipment Floater CPP0072114 1011/2018 10/112019 Limit 3,458,554 DESCRIPTION OF OPERATIONS 1 LOCATIONS f VEHICLES (AGORA 101,Addillonal Remarks Schedule,may he attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Gaunt Parks&Recreation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g Y ACCORDANCE WITH THE POLICY PROVISIONS. 6823 Miilhouse Road Chapel Hill,NC 27516 AUTHORIZED REPRESENTATIVE ACORD 25(2016/03) (9 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD