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DocuSign Envelope ID: 1BBBAFD6-1997-43E8-BE3E-9C058BE528AD <br /> ® DATE(MMrODIYYYY} <br /> CERTIFICATE OF LIABILITY INSURANCE 0312012019 <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 pDlicy(les)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain poIicles 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 Crystallreland <br /> Business Insurers of Carolinas AI�No Ext! (919)968-4611 alc,No {919)968-8991 <br /> 800 Eastowne Drive.Suite 208 E-MAIL eireland@business-insurers.com <br /> ADDRESS: <br /> PO Box 2536 INSURERS}AFFORDING COVERAGE NAIL Iv <br /> Chapel Hill NC 27515-2536 INSURERA: Travelers Indeminity 25658 <br /> INSURED INSURER H: Travelers Property Cas Cc of America 36161 <br /> Summit Design and Engineering Services PLLC INSURER D: Accident Fund Genera[Ins Co 12304 <br /> 504 Meadowlands Drive INSURER D: <br /> INSURER E <br /> Hilsborough NC 27278 INSURER F <br /> COVERAGES CERTIFICATE NUMBER. CL1932025274 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOMM MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LTR TYPE OF INSURANCE IN SO WvD POLICY NUMBER MMIODYIYYYY MMIDDIWYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY CURRENCE $ 1,000.000 <br /> EACHOC <br /> CLAIMS-MADE 7XI OCCUR PREMISES Ea occurrence 5 1Qa.aao <br /> MED EXP(Any one parson) y 5.000 <br /> A Y 6304KOB9149 01/01/2019 01/01/2020 PERSONAL&ADVINJURY s 1.000.000 <br /> GEN'L AGGR EGATE LIMITAPPLIES PER: GENERALAGGREGATE $ 2.000.000 <br /> POLICY A PRO- ❑ 2.000.000 <br /> JECT LOC PRODUCTS-COMPIOPAGG $ <br /> OTHER: S <br /> AUTOMOBILE LIABILITY CGNIIINED SINGLE LIMIT $ 1,000.000 <br /> Ea accident <br /> IX <br /> ANYAUTO BODILY INJURY(Per person) S <br /> AOWNED SCHEDULED Y 810-2J958216 04102/2019 04/02/2020 BODILY INJURY(Per acodent) S <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTYDAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> Experience Mad Factor 2 s <br /> X UMBRELLA LIAR 7[ OCCUR EACH OCCURRENCE $ 6,000,000 <br /> B EXCESS LIAR CLAIMS-MADE CUP4K264429 01/01/2019 01/01/2020 AGGREGATE S 6,000,000 <br /> OEb I x RETENTION$ 10,000 $ <br /> WORKERS COMPENSATION X STATUTE ]� ORH- <br /> AND EMPLOYERS'LIABILITY YIN _ <br /> ANY PRORRIETORIPARTNERIEXECUTIVE E.L EACH ACC IDENT S 1,aoa,aoa <br /> C OFFICERIMEMBER EXCLUDED? ❑ NIA WCV6179537 01/01/2019 01l01l2020 <br /> (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE 5 1,000,000 <br /> It yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ <br /> Excess Policy over GL•AU,VVC <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached It more space Is required) <br /> Project:Link Facility <br /> Orange County is included as Additional Insured with regards to General Liability and Auto Llability policy as required by written contract. <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 /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 200 S Cameron Street <br /> AUTHORIZED REPRESENTATIVE ) <br /> Hillsborough NC 27278 ./, P <br /> [c}1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The AC0RD name and Iogo are registered marks of AGORD <br />