2020-243-E AMS - Summit Design Motor Pool parking lot evaluation

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DocuSign Envelope ID:OEA8910E-53C5-4456-B7C4-13BO7A47BB46 ® DATE(MMOD"YY} CERTIFICATE OF LIABILITY INSURANCE 0312012019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not canter rights to the certificate holder in lieu of such eItdoraement(s). PRODUCER NAME T Crystallreland Business Insurers of Carolinas AICNo Ext: (919)968-4611 pAC,No: (919)968-8991 800 Eastowne Drive,Suite 208 E-MAIL eireland@business-insurers.com ADDRESS: PO Box 2536 INSURERS}AFFORDING COVERAGE NAIC Iv Chapel Hill NC 27515-2536 INSURERA: Travelers Indemnity 25658 INSURED INSURER n: Travelers Property Cas Cc of America 36161 Summit Design and Engineering Services PLLC INSURER c: Accident Fund Genera[Ins Co 12304 504 Meadowlands Drive INSURER D: INSURER E Hilsborough NC 27278 INSURER F COVERAGES CERTIFICATE NUMBER. CLI932025274 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE IN SO WvD POLICY NUMBER MMIODYIYYYY MMIDWYYYY LIMITS X COMMERCIAL GENERAL LIABILITY CURRENCE $ 1,000.000 EACHOC CLAIMS-MADE 7XI OCCUR PREMISES Ea occurrence 5 1Qa.aao MED EXP(Any one parson) $ 5.000 A Y 6304KOB9149 01/01/2019 01/01/2020 PERSONAL&ADVINJURY s 1.000.000 GEN'L AGGR EGATE LIMITAPPLIES PER: GENERALAGGREGATE s 2.000.000 POLICY PRO ❑ 2,000,oao JECT LOC PRODUCTS $ OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident IX ANYAUTO BODILY INJURY(Per person) S AOWNED SCHEDULED Y 810-2J958216 04102/2019 04/02/2020 BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident Experience Mad Factor 2 s x UMBRELLA LIAR 7[ OCCUR EACH OCCURRENCE S 6,000,000 B EXCESS LIAR CLAIMS-MADE CUP41<264429 01/01/2019 01/01/2020 AGGREGATE S 6,000,000 OEb I x RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY $TATLITE X ERH Y 1 N 1,000,000 ANY PRORRIETORIPARTNERIEXECUTIVE E.L EACH ACC IDENT s C` OFFICERIMEMBER EXCLUDED? ❑ NIA WCV6179537 01/01/2019 01l01l2020 (Mandatary in NH) E.L.DISEASE-EA EMPLOYEE 5 1,000,060 It yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Excess Policy over GL.AU,VVC DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached It more space Is required) Project:Link Facility Orange County is included as Additional Insured with regards to General Liability and Auto Liability policy as required by written Contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. 200 S Cameron Street AUTHORIZED REPRESENTATIVE ) Hillsborough NC 27278 ./, P CC}1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The AC0RD name and Iogo are registered marks of AGORD