Orange County NC Website
DocuSign Envelope ID: B59D5822-336E-40C5-911A-8FC53B025BA8 <br /> AGENCY CUSTOMER ID: 35MOSELARC <br /> LOC#: <br /> Ail f® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 <br /> AGENCY NAMED INSURED <br /> McGrifff Insurance Services Moseley Architects PC <br /> 3200 Norfolk Street <br /> POLICY NUMBER Richmond VA 23230 <br /> CARRIER NAIC CODE <br /> EFFECTIVE DATE: <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br /> Moseley Architects of Americas LLC <br /> BeeryRlo <br /> Moseley Architects <br /> Moseley Architects of South Carolina P.C. <br /> RE:Contract No.550352,Orange County New Detention Center Orange County,its officers,official agents and employees are included as Additional Insured <br /> wit11 respect to General Liability Coverage per Endorsement CGD381 09107,30 days'Notice of Cancellation other than nonpayment of premium will be sent to <br /> Orange County, Waiver of Subrogation is included with respect to Worker's Compensation Coverage. <br /> ACORD 101 (2008101) ©2006 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />