2019-496-E AMS - Muter Construction Seymour Center expansion

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DocuSign Envelope ID: 12DCC4E1-4D61-4DOE-A2A2-7C6E689613AC Client#: 1619133 20MUTERCON D/YYYI� E(MM/D ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATs/E(MM/D 9 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 have ADDITIONAL INSURED provisions or 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER N ONTA T AME: Bobbi Pendleton McGriff Insurance Services tic No :919 281-4500 FAX IM Ne: 8887468761 Post Office Box 13941 EMAIL ADDRESS: bpendieton@mcgriffinsurance.com b endleton riffinsurance.com Durham,NC 27709 INSURER(S)AFFORDING COVERAGE NAIC8 919 281-4500 INSURER A selective Insurance Co of the Southeast 39926 INSURED INSURER B:Builders Mutual Insurance Company 108" Muter Construction LLC INSURER C:Hanover Insurance Company 22292 100 N.Arendell Avenue 31194 �INSURER D:Travelers Casualty 8 surety er co of Am Zebulon,NC 27597 19489 INSURER E:Allied World Assurance Comparry US,Ine INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 ADDLSUB POLICY EFF POLICY EXP LTR INSR Yr4o POLICY NUMBER _ MM/DD MMIDD LIMITS A X COMMERCIAL GENERAL LIABILITY X X iS2371019 1/0812019 01/08/202 -EACH q�OECCC�URRENCE $1000000 CLAIMS-MADE 51 OCCUR PREMISES fEa o ourrence $5009 000 X Contractual Liab MED EXP(Any one person) $15000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 PR - POLICY[X]JECT u LOC PRODUCTS-COMP/OPAGG $3,000,000 OTHER: $ A AUTOMOBILE LIABILITY X X S2371019 1/0812019 0110812020 COMBINED SINGLE LIMIT 1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ X AUTOS ONLY X AUTOS ONLY Peracciden,. A X UMBRELLA LIAB X OCCUR X X S2371019 1110812019 01/0812020 EACH OCCURRENCE s5.000.000 EXCESS LIAB CLAIMS-MADE AGGREGATE s51000.000 DED I X RETENTION$O $ B WORKERS COMPENSATION X WCP106230201 1/08/2019 01/081202 X PER OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500,000 OFFICERIMEMBER EXCLUDED? � N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE1$500 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$500,000 C Builders Risk X IH6A09690205 9/03/2018 09/0312019 $10,000,0001$5,000,000 C Lease/Rent Equip IH6A09690205 9/03/2018 09/0312019 $500,000 D Crime 106891673 1/08/2019 01/0812026 $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:Orange County Southern Expansion Phase 1 Seymour Center Renovation and Addition Orange County,the Designer,the Designer's consultants and the Construction Manager are additional insured with respects to General Liability and Auto Liability arising from the operations of the named insured including completed operations as required with written contract.Coverage is primary non contributory. Waiver of subrogation applies to all policies including workers compensation. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Orange Count SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE g y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P O Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE ©1988.2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 2 The ACORD name and logo are registered marks of ACORD #S23866879/M23642578 BDPE