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DocuSign Envelope ID:3F1D7CF6-245A-4714-B5DB-30373AO5897A OP ID: DL
<br /> a dl--"Rt> CERTIFICATE 4F LIABILITY INSURANCE DATE 05/071201 YY)
<br /> 05107I2019
<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 poiicy(fes) 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 this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT
<br /> NAME; Kirk Brown
<br /> Diversified Insurance
<br /> Solutions LLC �°"�e KXt):919-471 8222 {Ai� No)-.919-471-6607
<br /> P.O.Box 15734 ADdRI�ss:kbrown diverseins.com
<br /> Durham,NC 27704- PRODUCER BR0WBR0
<br /> Diane S.Long CUSTOMER ID#:
<br /> INSURERS)AFFORDING COVERAGE NA]C#
<br /> INSURED Brown Brothers Plumbing and INSURERA:Builders Premier Insurance Co. 10844
<br /> Heating Company, Inc. INSURERS;Builders Mutual Insurance Co. 10844
<br /> 2820 N. Roxboro Road
<br /> Durham, NC 27704 INSURERC:Admiral Insurance Co. 44318
<br /> Durham, ---
<br /> INSURER D:Travelers PropertylCasualty 36161
<br /> INSURER E:
<br /> INSURER F:
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
<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 S BR POLICY EFF POLICY EXP
<br /> LTR POLICY NUMBER IMMIDDIYYYYI IMMIRDIYYYY LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
<br /> A X COMMERCIAL GENERAL LIABILITY X X �PCP0000055 10 12/3112018 12/3112019PIRE'.'ISEEST
<br /> RENTED Ea occurretice $ 300,000
<br /> CLAIMS-MADE OCCUR ED EXP(Any one person) $ 10,000
<br /> X contractual liab. __ PERSONAL&ADV INJURY $ 1,000,000
<br /> X i Deductible$500. GENERAL AGGREGATE $ 2,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER' PRODUCTS-COMPIOP AGG $ 2,000,000
<br /> POLICY X PRO- LOG $
<br /> AUTOMOBILE LIABILITY X X COMBINED SINGLE LIMIT • $ 1,000,000
<br /> (Ea accident)
<br /> A ANY AUTO PCA0006942 OS 12/31/2018 12131I2019 BODILY INJURY(Per person) $
<br /> X ALL OWNED AUTOS
<br /> BODILY INJURY(Per accident) $
<br /> SCHEDULED AUTOS
<br /> PROPERTY DAMAGE $
<br /> X HIRED AUTOS (PER ACCIDENT)
<br /> X NON-OWNEDAUT08 $
<br /> X Deductible -0- $
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ 5,000,000
<br /> S - MUB0004308 01 12131/2018 12/31/2019
<br /> DEDUCTIBLE $
<br /> X RETENTION $ 10,000 g
<br /> WORKERS COMPENSATION X WC STATU- OTH-
<br /> AND EMPLOYERS'LIABILITY T RY LIMIT ER
<br /> B ANY PROFRIETORIPARTNERIEXECUTIVE YIN NIA X WCP004435510 12131/2018 12/31/2019 E.L.EACH ACCIDENT ' $ 1,000,000
<br /> OFFICERIMEMBER EXCLUDED?
<br /> (Mandatory in NH) �E.L.DISEASE-EA EMPLOYEE $ 1,000,00
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS helaw L DISEASE-POLICY LIMIT $ 1,000,000
<br /> C Pollution Liab. FEI-ECC-22903-02 08/03/2018 08103/2019 OcclAggr. 2,000,000
<br /> D Third Party Crime 106446766 01/20/2019 01/20/2020 100,000 5000.ded.
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,It more space is required)
<br /> Project: Efland Cheeks Community Center water fountain replacement. Orange
<br /> County, &all others required by written contract are additional insureds
<br /> for ongoing&completed operations, on a primary&non-contributory basis,
<br /> and waivers of subrogation apply in their favor when regulred by written
<br /> c ontract, er attached forms&endorsements. Umbrella follows form.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange County, Dept. Of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> y p ACCORDANCE WITH THE POLICY PROVISIONS,
<br /> Environment,Agricultu re,Parks
<br /> &Recreation AUTHORIZED REPRESENT
<br /> PO Box 8181 Diane S. Long
<br /> Hillsborough, NC 27278
<br /> ©1988-2009 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD
<br />
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