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DocuSign Envelope ID: B75E8AA0-ADE3-4E77-B32C-2134D9CAA555
<br /> CTWILSO-01 LHAMLET
<br /> ACaIZa CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD/YYYY)
<br /> �� 12/2/2020
<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 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 Lori F. Hamlet
<br /> NAME:
<br /> Trisure,an Alera Group Company PHONE FAX
<br /> 4325 Lake Boone Trail,Suite 200 (A/C,No,Ext):(919)469-2473 (A/C,No):(919)467-4987
<br /> Raleigh,NC 27607 ADDRIESS:(hamlet@trisure.com
<br /> INSURERS AFFORDING COVERAGE NAIC#
<br /> INSURER A:Cincinnati Casualty Co. 28665
<br /> INSURED INSURER B:Cincinnati Insurance Co. 10677
<br /> CT Wilson Construction Co,Inc INSURER C:Selective Insurance Co. of America 12572
<br /> 150 Golden Drive,Suite 200 INSURER D:Allied World Assurance Company 19489
<br /> Durham,NC 27705
<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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
<br /> LTR INSD WVD MM/DDIYYYY
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR EPP 0149137 7/1/2020 7/1/2021 DAMAGE TO RENTED 500,000
<br /> X PREMISES Ea occurrence $
<br /> MED EXP(Any oneperson) $ 10,000
<br /> PERSONAL&ADV INJURY $ 1,000,000
<br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
<br /> X PRO-
<br /> POLICY LOC PRODUCTS-COMP/OP AGG $ 3,000,000
<br /> OTHER:
<br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
<br /> Ea accident $
<br /> X ANY AUTO EPP 0149137 7/1/2020 7/1/2021 BODILY INJURY Perperson) $
<br /> OWNED SCHEDULED
<br /> AUTOS ONLY AUTOS BODILY INJURY Per accident $
<br /> X HIRED X NON-OWNED PerOaccidenDAMAGE $
<br /> AUTOS ONLY AUTOS ONLY
<br /> $
<br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 15,000,000
<br /> EXCESS LIAB CLAIMS-MADE EPP 0149137 7/1/2020 7/1/2021 AGGREGATE $ 15,000,000
<br /> DED X RETENTION$ 0
<br /> B WORKERS COMPENSATION X PER OTH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> YIN EWC 0394380 7/1/2020 7/1/2021 1,000,000
<br /> ANY PROPRIETOR/PARTNER/EXECUTIVE L�J] N/A E.L.EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
<br /> If yes,describe under 1,000,000
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
<br /> C Rented/Leased Equip S 2128637 7/1/2020 7/1/2021 Limit 100,000
<br /> D Prof/Pollution 0310-8347 7/1/2020 7/1/2021 Limit 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Operations of the Named Insured covered by the above referenced policies.
<br /> C Builders Risk(Quarterly Reporting)Policy No.S2128637 7/1/2020 to 7/1/2021 Limit$10,000,000
<br /> Orange County is included as additional insured with respects to General Liability if required by written contract.
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange Count Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> 9 Y ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 300 W.Tyron Street,Room 240
<br /> Hillsborough,INC 27278
<br /> AUTHORIZED REPRESENTATIVE
<br /> I ADU 4 xwngr
<br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved.
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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