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DocuSign Envelope ID:ODC20FEA-61BA-4E8D-BB15-F9F832183998 <br /> DATE(MM/DDIYYYY) <br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE <br /> �� 11/16/2020 <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 <br /> NAME: Sandy Krevonick <br /> McGrifff Insurance Services PHONE FAx <br /> 2108 W. Laburnum Ave Suite 300 AIC No Ext: 804-678-5026 AIC No):888-751-3010 <br /> PO Box 17370 ADDRESS: certificatesvawv@mcgriffinsurance.com <br /> Richmond VA 23227 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Travelers Property Casualty Co of Amer 25674 <br /> INSURED 35MOSELARC INSURER B:Travelers Casualty&Surety Company 19038 <br /> Moseley Architects PC <br /> 6210 Ardrey Kell Rd, Suite 425 INSURERC:XL Specialty Insurance Company 37885 <br /> Charlotte, NC 28277 INSURERD: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1369531888 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 EFF POLICY EXP LIMITS <br /> LTR INSD WVD POLICY NUMBER MM/DDIYYYY MM/DDIYYYY <br /> A X COMMERCIAL GENERAL LIABILITY 680OJ6764142047 5/6/2020 5/6/2021 EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE OCCUR PREM SES�RENTE a o_cur ence $1,000,000 <br /> MED EXP(Any one person) $10,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 <br /> POLICY❑ PRO- � <br /> JECT LOC PRODUCTS-COMP/OP AGG $2,000,000 <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY BA1613L67320GRP 5/6/2020 5/6/2021 COEaMBINED accident SINGLE LIMIT $1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> X HIRED X NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> A X UMBRELLA LIAB OCCUR CUP6687Y2042047 5/6/2020 5/6/2021 EACH OCCURRENCE $10,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 <br /> DED X RETENTION$In nnn $ <br /> B WORKERS COMPENSATION UB4K824622204E 5/1/2020 5/1/2021 X PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 <br /> C Professional DPR9951460 12/1/2019 12/1/2020 Per Claim $4,000,000 <br /> Liability Aggregate $6,000,000 <br /> Deductible $200,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Umbrella Liability does not extend over Professional Liability <br /> Additional Named Insureds: <br /> Moseley Architects PC <br /> Moseley Scott's Addition LLC <br /> Moseley Architects of Maryland Inc. <br /> Moseley Architects North Carolina PC <br /> Moseley Architects of Virginia LLC <br /> See Attached... <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County <br /> PO Box 8181 <br /> Hillsborough NC 27278-2505 AUTHORIZED REPRESENTATIVE <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />