2021-018-E AMS-Chapel Hill Moving Company Europa Center

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DocuSign Envelope ID: EOD035CF-BC7E-4E6F-8A43-79902D1DE39E CHAPHIL-01 GBRYAN ,4coR0` CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/14/2020 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(ies)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 confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Harold W.Wells&Son,Inc. PHONE FAX 1 IN3rd Street (A/C,No,Ext): (910)762-8551 (A/C,No):(910)254-9404 Wilmington,NC 28401 ADDRESS:insurance@WeliSins.COm INSURERS AFFORDING COVERAGE NAIC# INSURER A:TransGuard Insurance Company of America Inc INSURED INSURER B:Brill efield Casualty Insurance 10335 Chapel Hill Moving Company INSURER C: 7401 Rex Road Ste 104 INSURER D: Chapel Hill, INC 27516 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM DD YYY MM DD YYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR TCP000137502 4/1/2020 4/1/2021 DAMAGE TO RENTED 100,000 LAA1X X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY El PECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 Ea accident $ ANY AUTO X X TCP000137502 4/1/2020 4/1/2021 BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY X AUTOS BODILY INJURY Per accident $ X HIRED X NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident) ent $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ B WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER Y/N 196-40672 4/1/2020 4/1/2021 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE LY] N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under 500,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Cargo TCP000137502 4/1/2020 4/1/2021 Per Loss 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Ethan Smith and Patricia Brummitt are excluded with regard to Workers'Compensation The certificate holder is an additional insured with regard to General Liability and Automobile Liability when required by written contract or agreement. Waiver of Subrogation applies with regard to General Liability and Automobile Liability when required by written contract or agreement.Notice of cancellation is afforded to the First Named Insured as per the policy terms and provisions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange Count THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 9 y ACCORDANCE WITH THE POLICY PROVISIONS. P O Box 8181 Hillsborough,INC 27278 AUTHORIZED REPRESENTATIVE t,rw.0 ACORD 25(2016/03) U ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD