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DocuSign Envelope ID:4BF6293F-43AD-455F-9A97-1356B84BD34E
<br /> ^1 OP ID: DL
<br /> CERTIFICATE OF LIABILITY INSURANCE DATE 1211 6/20 1 9Y)
<br /> 1211fi12019
<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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> PRODUCER CONTACT Kirk Brown
<br /> Diversified Insurance
<br /> Solutions LLC aHONNo Ext�:919 471-8222 EAX Nol: 919-471-6607
<br /> P.O.Box 16734 E-MAIL kbrown diverseins.com
<br /> Durham,NC 27704- ADDRESS: _
<br /> Diane S. Lon PRODUCER BROWBRO
<br /> g CUSTOMER ID#:
<br /> „_ ,,___ INSURERS)AFFORDING COVERAGE _ NAIC#
<br /> INSURED Brown th Broers Plumbing and INSURER A:Builders Premier Insurance Co. 10844
<br /> Heating Company, Inc. INSURER a:Builders Mutual Insurance Co. 10844
<br /> 2820 N. Roxboro Road Durham, NC 27704 INSURER C:Admiral Insurance Co. 44318
<br /> INSURER 0:Travelers Propeqytqasualty 36161
<br /> INSURER E:
<br /> 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 /> 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 /> n1X
<br /> _ POLICYEFF POLICY EXP TYPE OF INSURANCE POLICY NUMBER MMIDUNYYY MMIDDIYYYY LIMITS
<br /> L LIABILITYEACH OCCURRENCE $ 1,OOO,DOO
<br /> MMERCIAL GENERAL LIABILITY PGPOO00055 11 12131/2019 12131/2020 DAMAGETO RENTEDPREMISES Ea occurrence $ 300,000
<br /> CLAIMS-MADE 1KOCCUR MED EXP(Any one person) E $ 10,000
<br /> traCtualliab. PERSONAL&ADVINJURY S 1,000,000
<br /> x Deductible$500. _ GENERAL AGGREGATE _$ 2,000,00
<br /> G_EVLAGGREGGA;TELIMITAPPLIESPER: PRODUCTS-CDMPlOPAGG $ 2,000,000
<br /> POLICY I Jl PRO LOC
<br /> $ _
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> A X ANY AUTO PCA0006942 09 12/3112019 12/31/2020 (Eaaccrdenq $ 1,000,000
<br /> X ALL OWNED AUTOS
<br /> LEIODI
<br /> Y IN.IURY(Per person} $
<br /> Y INJUR Y(Per accident] $
<br /> SCHEDULED AUTOS
<br /> PROPERTY DAMAGE
<br /> X HIREDAUTOS (PER ACCIDENT) $
<br /> X_ NON-OWNED AUTOS 5
<br /> X ,Deductible -0-
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> eXCHSS LL AD CLAIMS-MADE -
<br /> B MUB0004308 01 12/31/2019 12/31/2020�EC.ATE g 5,000,000
<br /> DEDUCTIBLE
<br /> X RETENTION $ 10,000 I $
<br /> WORKERS COMPENSATION X WC STATU- OTH-
<br /> AND EMPLOYERS'LIABILITY Y 1 N I TORY LIMITS ER _
<br /> B ANY FROPRIETOWFARTNFRIEXECUTIVE WCP004435511 121311201911213112020 A T 1,000,000OFFICERIMEMBER EXCLUDED? N/A E. .ECHACCIDEN
<br /> _
<br /> (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ 1,000,000
<br /> I`yes,describe under _ __
<br /> DESCRIPTION OF OPERATIONS below E L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> C ,Pollution Liab. FEI-ECG-22903-03 08103/2019 08103/2020 OcclAggr, 2,000,000
<br /> D Third Party Crime 106446766 01120/2020 01/20/2021 100,000 5000.ded.
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required)
<br /> email to:acooper@orangecountync.gov
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANC07
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> P.O. BOX 8181
<br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE
<br /> Diane S. Long lI
<br /> O 1988-2009 ACORD CORPORATION. All rights reserved-
<br /> ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD
<br />
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