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DocuSign Envelope ID: FOFFDO49-5CF1-497C-8288-4E926CBOCCC4 <br /> DATE(MMIDDIYYYYI <br /> ACC)R" CERTIFICATE OF LIABILITY INSURANCE 0411612019 <br /> �4—� F <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('ses)must have ADDITIONAL INSURED provisions or he endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain poficles may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such en lorsement(s). <br /> CONTACT Trish Clark <br /> PRODUCER NAME: <br /> Trustpoint Insurance PHONE <br /> Exs: (540)389-U2fi1 Ate,Ne: (588)872-5496 <br /> 18 East Church Ave E-MAILADDRE s: iclarka�trusipointins.com <br /> IN SURER(S)AFFORDING COVERAGE NAiC tf <br /> Roanoke VA 24010 WSURERA: AXIS Insurance Company <br /> INSURED INSURER B <br /> Riley Surveying,P.A. INSURER C <br /> 3326 Durham Chapel Hill Blvd INSURER D: <br /> INSURER E <br /> Ste B-100 Dur NG 27707 INSURER F <br /> COVERAGES CERTIFICATE NUMBER: 16-19 Master REVISION NUMBER: <br /> THI5 lS 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 CONTRACTOR OTHER DOCUMENT WITH RESPECTTO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN TS SUBJECT To ALL THE TERMS, <br /> E XCLUSIONS AN D CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> POLICY EFF POLICY EXP <br /> ILTRR TYPE OF INSURANCE I SD WvD POLICY NUMBER MMfODIYYYY MMIDDIYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ <br /> DAMAGE TO RENTED <br /> CLAIMS-MADE OCCUR PREMISES Ea ouunence S <br /> MED EXP(Aroy aneperson) $ <br /> PERSONAL&ADV INJURY 5 <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S <br /> ❑PRO- ❑LCC PRObUCTS-COMPIOP AGG $ <br /> POLICY JECT 5 <br /> OTHER <br /> AUTOMOBILE LIABILITY Ea awdeni SINGLE LIMIT <br /> $ <br /> ANY AUTO BODILY INJURY(Per person) 5 <br /> OWNED SCHEDULEQ BODILY I NJU RY(Per accAanl) 5 <br /> AUTOS ONLY AUTDS <br /> HIRED NON-OWNED PRDPERTY DAMAGE 5 <br /> AUTOS ONLY AUTOS ONLY Per.atxident) <br /> 5 <br /> UMBRELLA LIA8 OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS,MADE AGGREGATE 5 <br /> DED I I RETENTION$ $ <br /> PER OTH• <br /> WORKERS COI-0PENSATION PER <br /> ER <br /> AND EMPLOYERS'LIABILITY y I N <br /> ANY PROPRIETORIPARTNERIEXECUTWE ❑ NIA E.L.EACH ACCIDENT 5 <br /> OFFIC£RIMEMBER EXCLUDED? <br /> IMandatury in NH] E.L.DISEASE-EA EMPLOYEE 5 <br /> If Year describe undor <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S <br /> Per Claim $1,000,000 <br /> A Professional Liability AEA003488-01-2018 08/10/2018 05/10/2020 Aggregate $2,000,000 <br /> Deductible $2,500 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEH IC LES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Orange County Environmental Agriculture, ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Parks and Recreation <br /> AUTHORIZED REPRESENTATIVE <br /> 306A Revere Road / <br /> Hillsborough NC 27278 <br /> lJ 01988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2016103) The ACORD name and IDgo are registered marks of ACORD <br />