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DocuSign Envelope ID:8433EODF-BA45-445A-8ECO-92271C65CC98 <br /> DATEIMMOD?YYYYI <br /> ,aco�o® CERTIFICATE OF LIABILITY INSURANCEF��. 01/06/2020 <br /> THIS CERTIFICATE IS ISSUED AS A NIATTER OF INFORNIA71ON ONLY AND CONFERS NO RIGHTS UPON THE CERTEFICATE 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 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: Calla Moore <br /> Colonial Insurance Agency Hillsborough nr'C' (919)732 2191 aIc No; (919}732 2192 <br /> 103 Millstone Dr.Suite A EMAIL ADDRESS, .com <br /> caa colonial-a enc <br /> ADDRESS: ca0a@colonial-agency.com <br /> Y <br /> Po Box 490 INSURER 8 AFFORDING COVERAGE NAIL# <br /> Hillsborough NC 27278 INSURERA: Starr Surplus Lines ins.Co. 13604 <br /> INSURED INSURER B <br /> Summit Design And Engineering Services, PLLC INSURER C <br /> 320 Executive Court 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 /> 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 /> NSR ADOLSUBR POLICY E <br /> LTR TYPE OF INSURANCE INSD WVQ POLICY NUMBER MWDDIYYYY) fMM1DD`YYYYl LIMITS <br /> CQMMERCIAL GENE PAL LIABILITY EACHOCCURRENCE $ <br /> CLAIMS-MADE OCCUR PREMISES a cecurrence $ <br /> MED EXP(Arty 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 COMBINED SINGLE LIMrr $ <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 /> ?DED <br /> XCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> I I RETENTION$ $ <br /> WO RKE R 9 CO MP EN SA MON <br /> AN[)EMPLOYERS'LIABILJTY Y r N STATUTE I I ERH <br /> ANY PROPRIETORPARTNER'EXECLITIVE E.L.EACH ACCIDENT $ <br /> 0FFICER:tv1EMBER EXCLUDED? NIA <br /> (Mandatoryin NH) E.L.DISEASE-EA EMPLOYE $ <br /> Iryes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> Professional, E&O Contractors Occurence 6,000,000 <br /> A Pollution Liability N N SLSL-PRO-262380-19 04/02/2019 04I0212020 Aggregate 5,000,000 <br /> ❑ESCRiPTION OF OPERATIONS+LOCATIONS I VEHICLES (ACORD 101.Additional Remarks Schedule.may be attached it more space is required) <br /> Project: Capital Projects <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 Asset Management Services ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 131 W Margaret Lane <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> Fax: Email'alaarnes@orangecountync.gov Q 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACOR❑ <br />