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DocuSign Envelope ID:8880C4F3-E132-469D-9F1A-0516B69BADB7 <br /> Client#: 1229721 SUSANHAT <br /> M+12020 DDlY YYY) <br /> ACDRDrI CERTIFICATE OF LIABILITY INSURANCE 1r29 PATE{M11 WDDIY <br /> THIS CERTIFICATE IS#SSUE❑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 INSURERS),AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the pvlicy(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 any rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT select Commercial <br /> NAME: <br /> USI Insurance Services LLC I PHONE 855 874-0777 610.362.8101 <br /> {A+C,ND.Ext1: C No: <br /> 1715 N.Westshore Blvd., .Shiite 700 E-MAIL <br /> A__nDR <br /> Tampa, FL 33607 INSURE R(SI AFFORDING COVERAGE NAICN <br /> 855 874-1270 INSURER A:Cohtrheht-1Ga alpfC—Pahy 20443 <br /> INSURED INSURER a: <br /> Susan Hatchell Landscape <br /> INSURER C: <br /> Architecture,PLLC <br /> INsuRraz D- <br /> 711 W. North Street <br /> INSURERE; <br /> Raleigh,NC 27603 <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 CONTRACTOR 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 /> LT R TYPE OF INSURANCE ADDL SUB POLICY NUMBER MM DS h6MwA LIMITS <br /> LTR. <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> CLAIMS-MADE OCCUR PREMISES Ear ante $ <br /> MED EXP{Any Dne Damon $ <br /> PERSONAL&AOV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ <br /> ❑JE C- PRODUCTS-COMPIOP AGG $ <br /> PRO, LOC POLICY <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea acdde <br /> ANY AUTO BOLALY INJURY(Per person) S <br /> OWNED SCHEDULED BODILY INJURY(Per accident) S <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAAAAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accidenl <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEQ I I RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LABILITY <br /> ANY PROPRIETORIPARTNEMXECUTIVE YIN E.L.EACH ACCIDENT $ <br /> OF FICE RIMEMS E R EXCLUDED? N1A <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A Professional Liab LAH591856713 5/01/2019 0510112022 1,000,000 <br /> 2,000,000 Aggregate <br /> $3 000 Deductible <br /> DESCRIPTION OF OPERATIONSI LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required} <br /> Project: Blackwood Farm Park <br /> CERTIFICATE HOLDER CANCELLATION <br /> Marat]eth Carr,ASLA 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 /> P.O Box 8181 <br /> Hillsborough, NC 27278 A UTHO RIZED R E PR E S E NTATI VE <br /> ©1988-2015 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(201611)3) 1 ❑f 1 The ACORD name and logo are registered marks of ACORD <br /> #S27800080IM25715827 DXPEW <br />