2019-356-E Planning - Tischler Bise Fiscal Economic Model consulting

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DocuSign Envelope ID:49DCCCCF-BDED-4EDB-A3D5-579B6C96F48E 0 DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 6/21/2019 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 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 Mart Ramey NAME: y y Henry A Latimer and Son, Inc. PAHic NN Ext: (301)229-1500 ac No: (301)320-2958 4701 Sangamore Rd. Suite S-250 ADDRESS: INSURERS AFFORDING COVERAGE NAIC# Bethesda MD 20816 INSURER A:Erie Insurance Company 26263 INSURED INSURER B:Erie Insurance Exchange 26271 Tischler Bise INSURER C:Travelers Indemnity Company 4701 Sangamore Rd INSURER D:Travelers Indemnity Co Suite S240 INSURER E: Bethesda MD 20816 INSURER F: COVERAGES CERTIFICATE NUMBER:Master 19-20 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 SUBD R POLICY EFF POLICY EXP LIMITS LTR IN WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE �X PREMISESS Ea occurrence $OCCUR DAMAGE (RENTED 1,000,000 PREMI Q970143648 6/1/2019 6/1/2020 MED EXP(Any one person) $ 5,000 PERSONAL &ADV INJURY $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT X OTHER: EMPLOYEE DISHONESTY EMPLOYEE DISHONESTY $ 100,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANYAUTO BODILY INJURY(Per person) $ A ALL OWNED SCHEDULED AUTOS AUTOS Q970143648 6/1/2019 6/1/2020 BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE KX HIREDAUTOS N AUTOS Per accident) ccident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 B EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED RETENTION $ Q300171541 6/1/2019 6/1/2020 $ WORKERS COMPENSATION x PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A C (Mandatory in NH) UBOON202196 06/01/2019 06/01/2020 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 D Professional Liability 105783307 5/28/2019 5/28/2020 $1,000,000 claims made DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Orange County Planning and Inspections Department its officers, elected and appointed officials, employees and agents can be listed as the additional insured. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Planning and Inspections De THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN 131 W. Margaret Lane, Ste 201 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE R Latimer, Jr./MARTY �' t ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)