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DocuSign Envelope ID:960ABE7A-606F-4A95-858E-6C13A445B70B
<br /> 1 OP ID:DL
<br /> CERTIFICATE 4F LIABILITY INSURANCE []1211712018
<br /> AYE(MMfY}
<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(ies) 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 CONTANAME:CT Kirk Brown
<br /> Diversified Insurance PHONE FAX
<br /> Solutions LLC N,,No E�t:919-471-8222 AIC No}:919-471-6607
<br /> P.O.Box 15734 E-MAIL
<br /> ADDRESS:kbrown@ddiverseins.com
<br /> Durham,NC 27704- PRODUCER "
<br /> Diane S.Long cusroMElt ro#:BROWBRO
<br /> AfTORDFNG COVERAGE_ _ NAIC# _
<br /> INSURED Brown Brothers Plumbing and INSURERA:Builders Premier Insurance Co. 10844
<br /> Heating Company,Inc. INSURERS:Builders Mutual Insurance Co. 108"
<br /> 2820 N. Roxboro Road INSURER C:Admiral Insurance Co. 44318
<br /> Durham, NC 27704 INSURER D;Travelers Property/Casualty 36161
<br /> INSURER E:
<br /> INSURER E
<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 SUBR POLICY NUMBER MMLDDIYYYY MMfVDNYYY I LIMITS
<br /> LTR
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00
<br /> PCP0000055 10 1213112018 12131/2019 oAMA�TO RED 300,0
<br /> A X_ COMMERCIAL GENERAL LfA61L17V PREMISES[E2 occurrence} $
<br /> CLAIMS-MADE L,& OCCUR MED EXP{Any one person} $ 10,00
<br /> X contractual liab. PERSONAL&ADVINJURY $ 1,000,00
<br /> i Deductible$500. GENERAL AGGREGATE $ 2,000,00
<br /> GENT AGGREGATE LIMIT APPLES PER: PRODUCTS-COMPIOP AGG $ 2,000,00
<br /> POLICY X JECT
<br /> PRO- LOC
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00
<br /> PCA0006942 08 12/31/2018 12/31/2019 {Ea accident)
<br /> A X ANY AUTO BODILY INJURY(Per person) $
<br /> X ALL OWNED AUTOS BODILY INJURY(Per accldenU $
<br /> SCHEDULED AUTOS .
<br /> PROPERTY DAMAGE
<br /> "X HIRED AUTOS (PER ACCIDENT) $
<br /> X NON-OWNEDAUTOS _
<br /> X Deductible -0- $
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 55,000,0U
<br /> EXCESSuAR "`_ft LAIMS-MADE �MUB0004308 01 12/31/2018 12131/2019 AGGREGATE_ $ 5,000,00
<br /> PDEDUCTIBLE $
<br /> X , RETENTION $ 10,000 $
<br /> WORKERS COMPENSATION X WC STATU- OTH-
<br /> AND EMPLOYERS'LIABILITY _ TORY LIMITS FR
<br /> B ANY PROPRIETORIPARTNERIFXECUTIVE YIN .WCP0044355 10 12/3112018 12/31/2019 E_L.EACH ACCIDENT $ 1,000,00
<br /> OFFICERIMEMBER EXCLUDED'+ �j N!A
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE'$ 1,000,00
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E,L.DISEASE-POLICY LIMIT $ 1,000,00
<br /> C �Poilution,Liab. 1-EI-ECC-22903-02 08/03/2018 08/03/2019 Occ/Aggr. 2,000,00
<br /> D Third Party Crime 106446766 0112012019 01(2012020 100,000 5000.ded,
<br /> DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (Attach ACORD fOf,Additional Remarks Schedule,if more space is required)
<br /> email to:acooper@orangecountync.gov
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANC07
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> P.O. Box 8181
<br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE
<br /> Diane S. Long
<br /> (D 1988-2009 ACORD CORPORATION. All rights reserved.
<br /> ACORt7 25(2009109) The ACORD name and logo are registered marks of ACORD
<br />
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