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DocuSign Envelope ID:AAOD69CA-7549-4F42-9DB3-55679AC61BB3 OP ID: DL <br /> ^1 <br /> ,acoRn CERTIFICATE OF LIABILITY INSURANCE FD 12 16/2 Y9 <br /> �� 1 211 612 0 1 9 <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 /> CONTACT Kirk Brown <br /> PRODUCER NAME: <br /> Diversified Insurance PHONE 919 471-8222 PAC,No: 919-471-6607 <br /> Solutions LLC A C No Ext: <br /> P.O.Box 15734 E-MAIL SS:kbrown@diverseins.com --- <br /> Durham,NC 27704- PRODUCER gROWBRO <br /> Diane S. Long CUSTOMER ID N: W. — <br /> INSURER(S)AFFORDING GOVERAGE NAIC 0 <br /> INSURED Brown Brothers Plumbing and INSURER A:Builders Premier Insurance Co. 10844 <br /> Heating Company, Inc. INSURER B;Builders Mutual Insurance Co. 10344 <br /> 2820 N. Roxboro Road INSURER C:Admiral Insurance CO. 44318 <br /> Durham, NC 27704 <br /> INSURER D:Travelers Proper'tylCasualty 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 /> INSR _ AD DL:SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR TYPE OF INSURANCE R WVD: POLICY NUMBER MMIDUNYYY MMIDDIYYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> PGP0000055 11 12131I2019 12131I2020 PREMISES Ea occurrence $ 300,000 <br /> CLAIMS-MADE Fx7 OCCUR MED EXP(Any one person) $ 10,000 <br /> X contractual liab. PERSONAL&ADV INJURY S 1,000,000 <br /> X Deductible$500. GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ _2,000,000 <br /> POLICY I^ PRO- TOO _ $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 <br /> (Ea accident) <br /> A X ANY AUTO PCA0006942 09 12/3112019 12/31/2020 <br /> BODILY INJURY(Per person} $ <br /> X ALL OWNED AUTOS BODILY INJURY(Per accident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> $ <br /> X HIREDAUTOS (PER ACCIDENT) <br /> X_ NON-OWNED AUTOS S - -- <br /> X Deductible -0- $ <br /> X UMBRELLA LIAB X OCCUR EACH CCCURRENCE $ 5,000,000 <br /> ExCESS LIAD AGGREGATE $ 5e0Q0,0{]0 <br /> B cl alms-Mane MUB0004308 01 12/3112019 12/3112020 <br /> DEDUCTIBLE - $ - <br /> X RETENTION $ 10,000 $ <br /> WORKERS COMPENSATION X WC TORY LIMITS I FIR <br /> _ <br /> AND EMPLOYERS'LIABILITY YIN 1,000,000 <br /> B ANY PROPRIETOR/PARTNFRIEXECUTIVE WCP0044355 11 12/31/2019 12/31/2020 EL EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? N I A <br /> (Mandatory in NH) EL,DI SEAS SE-EA EMPLOYEE $ _ 1,000,000 <br /> I^yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> C Pollution Liab. FEI-ECC-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 1 LOCATIONS I VEHICLES (Attach ACIDRD 101,Additional Remarks Schedule,if more space is required) <br /> email to: acooper@orangecountync.gov il <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANC07 <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 /> P.O. Box 8181 <br /> Hillsborough, INC 27278 AUTHORIZED REPRESENTATIVE <br /> Diane S. Long <br /> O 1988-2009 ACORD CORPORATION. All rights reserved- <br /> ACORD 26(2009109) The ACORD name and logo are registered marks of ACORD <br />