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DocuSign Envelope ID: B59D5822-336E-40C5-911A-8FC53B025BA8 <br /> �a CERTIFICATE OF LIABILITY INSURANCE <br /> HATE{MMlDOIYYYY) <br /> 413012019 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLIER. 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 certfficate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER NAME:CT Sandy Krevonick <br /> McGrifff Insurance Services PHONE FAX <br /> 2108 W. Laburnum Ave Suite 300 ,804 fi78-5026 we No:888-751-301D <br /> PQ Box 17370 E-MAIL oertificatesvawv@mcgriffinsuranoo.com <br /> Richmond VA 23227 INSURER$AFFORDING COVERAGE NAICY <br /> INSURER A:Travelers Indemnity Company 25658 <br /> INSURED 35MOSELARC INSURER B:Travelers Property Casualty Co of Amer 25674 <br /> Moseley Architects PC INSURER c:Travelers Casualty&Surety Company 19038 <br /> 3200 Norfolk Street <br /> Richmond VA 23230 INSURER o-.XL Specialty Insurance Company 37895 <br /> INSURER E <br /> INSURERF: <br /> COVERAGES CERTIFICATE NUMBER:1082996428 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 /> ADDLPO <br /> INSR TYPE OF INSURANCE JIM 8U D POLICY NUMBER PM DDPnFYY MMLDOOY EXP LIMITS <br /> LTR <br /> a X COMMERCIAL GENERAL LIABILITY 680CJ6764141847 5/6/2019 5/6/2020 EACH OCCURRENCE $1.000,000 <br /> CLAIMS-MADE FXI OCCUR PRE"SES Ea occurrence $1,000,000 <br /> MEP EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $1,000,00o <br /> GEN'L AGGREGATE I.I MIT APPLIES PER: GENERAL AGGREGATE $2,000.000 <br /> POLICY O JECT ff]LOC PRODUCTS-COMPIOP AGG $2,000 000 <br /> OTHER: $ <br /> 8 AUTOMOBILEUABIUrrY BA11613L67318GRP 5/6/2019 5/9/2020 COM6IdEll erdl GLELIMET 51 Q00,bbb <br /> Ea a Id nt <br /> IX ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Peracddent) $ <br /> AUTOS ONLY AUTOS <br /> x HIRED X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY er accIderd <br /> A X UMBRELLA LIA8 OCCUR CUP6687Y2041847 5/8/2019 5/6/2020 EACHOCCURRENCE $5.000,000 <br /> EXCESS LIAR HCLAIMS-MADE AGGREGATE $5,000 000 <br /> DED I X RETENTION $ <br /> C WDRKERSCOMPENSATION U134IC8246221847E 5/112DIS 5/1/2020 )C I <br /> STATUTE ERH <br /> AND EMPLOYERS'LIABILITY Y I H <br /> ANYPROPRIETOR/PARTNER1EXEClJTiVE NIA E.L.EACH ACCIDENT $1 000.000 <br /> O FFIC EWM EMBER EXC LU DE D7 <br /> (Mandatory Id NH) E.L.DISEASE-EA EMPLOYEE $1,000.000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below ! E.L.DISEASE-POLICY LIMIT $1,000.000 <br /> D Professlonal DPR9932712 12/1/2018 IVII2019 Per Claw $4,000,000 <br /> Llablllty Dad flab a $fi,000,000 <br /> ucil $200,0o0 <br /> DESCRIPTION OF 0PERATIONS I LOCATIONS I VEHICLES IACORO 101,Add Vona[Remarks Schedule,may be attached If moreapaca I required) <br /> Umbrella Llab'tlity does not extend over Professional Liability <br /> Additional Named Insureds: <br /> Moseley Architects PC <br /> Moseley Scoi#'s Addition LLC <br /> Moseley Architects of Maryland Inc. <br /> Moseley Architects North Carolina PC <br /> Moseley Acchitects of Virginia LLC <br /> See Attached... <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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ❑range County <br /> PO Box 8181 <br /> Hillsborough NC 27278-2505 AUTHORIZED REPRESENTATIVE <br /> ©1985-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />