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DocuSign Envelope ID: F55E53DA-6231-4A93-9BFA-2ADD5323B355 <br /> ACQRE� CERTIFICATE OF LIABILITY INSURANCE DATE(MMiDDIYYYY) <br /> ��. 0511712019 <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(les)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 CONTACT <br /> NAME: Carla Moore <br /> Colonial Insurance Agency Hillsborough PHONE (919)732 2191 aIc No; (919)732 2192 <br /> 103 Millstone Dr.Suite A E-MAIL ADDRESS, .com <br /> caa colonial-a enc <br /> RDDRESS: ca0a@colonial-agency.com <br /> Y <br /> PC Box 490 INSURER 8 AFFORDING COVERAGE NAIL# <br /> Hillsborough NC 27278 INSURER A: Starr Surplus Lines Ins.Co. 13604 <br /> INSURED INSURER B <br /> Summit Design And Engineering Services, PLLC INSURER C <br /> 504 Meadowlands Drive INSURER D <br /> INSURER E <br /> Hillsborough NC 27278 INSURER F <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 /> INDICATE[). 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 /> 1NSR ADDLSUBR POLICY E <br /> LTR TYPE OF INSURANCE INSD WVQ POLICY NUMBER MMIDDIYYYY) fMM1DDfYYYY1 LIMITS <br /> CQMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> iol <br /> CLAIMS-MADE OCCUR PREMISES a occurrence $ <br /> MED EXP(Any orre person) $ <br /> PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ <br /> POLICY jECT LOC -PRO DUCTS-COMP+OPAGG $ <br /> OTHER $ <br /> AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT $ <br /> Ea accident <br /> ANYAUTO BODILYINJURY(Per person) $ <br /> OWNED SCHEDULED BO DI LY IN JU RY(Per acc ident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED ROPERTY D AGE $ <br /> AUTOS ONLY AUTOS ONLY PeracU $ <br /> c!deni <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DE❑ I I RETENTION$ $ <br /> WCRKER9COMPENSATON <br /> AND EMPLOYERS'UARILJTY YIN STATUTE I I ERH <br /> ANY PROPRIETORPARTNER'EXECIITIVE E.L.EACH ACCIDENT $ <br /> OFFICER-IMINBER EXCLUDED? NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS beidw E.L.DISEASE-POLICY LIMIT $ <br /> Professional, E&O Contractors Occurence 5.000,000 <br /> A Pollution Liability N N SLSL-PRO-262380-19 04/02/2019 04/02/2020 Aggregate 5,000,000 <br /> DESCRIPTIDN OF 0PERATONS 1 LOCATIONS I VEHICLES;A CORD 101,Additional Remarks Schedule,may be attached if more space Is requiredI <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF TIE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County Asset Management Services ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 131 W Margaret Lane <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> Fax: Email�abarnes@orangecountync.gov O 1988-2015ACORD CORPORATION. Ali rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br />