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DocuSign Envelope ID: E27BCFAF-D97D-4E90-B3D4-B33F96BBE4D6 <br /> DATE(MM/DDIYYYY) <br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE <br /> �� 11/11/2021 <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: Carrie West <br /> Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX <br /> 4250 Congress Street, Ste. 200 AIC No Ext: 984-328-7660 A/c No), <br /> Charlotte NC 28209-4615 ADDRESS: Carrie West@ajg.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Travelers Property Casualty Co of America 25674 <br /> INSURED INSURER B: Phoenix Insurance Company 25623 <br /> Systel Business Equipment, Inc <br /> P O Box 35910 INSURER C:Travelers Indemnity Company 25658 <br /> Fayetteville, NC 28303-5910 INSURERD: <br /> INSURER E <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER:181754344 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 /> C X COMMERCIAL GENERAL LIABILITY 63082831366820 11/1/2021 11/1/2022 EACH OCCURRENCE $1,000,000 <br /> CLAIMS-MADE OCCUR PREM SES�RENTE a o_cur ence $100,000 <br /> MED EXP(Any one person) $5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $3,000,000 <br /> POLICY❑ PRO- <br /> JECT ❑ LOC PRODUCTS-COMP/OP AGG $2,000,000 <br /> X <br /> OTHER: $ <br /> A AUTOMOBILE LIABILITY 81082831367A20 11/1/2021 11/1/2022 COMBINED SINGLE LIMIT $1,000,000 <br /> Ea accident <br /> X ANY AUTO BODILY INJURY(Per person) $ <br /> X 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 /> X Phys.Dam. X $75,000 $ <br /> A X UMBRELLA LIAB X OCCUR CUP7J36031220 11/1/2021 11/1/2022 EACH OCCURRENCE $20,000,000 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $20,000,000 <br /> DED X RETENTION$ $ <br /> B WORKERS COMPENSATION UB7J69193620 11/1/2021 11/1/2022 X PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $500,000 <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $500,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 <br /> A Auto Physical Damage 8108283B67A20 11/1/2021 11/1/2022 $1,000 Deductible Comprehensive <br /> $1,000 Deductible Collision <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> General Liability Form CGT100 0219 Includes Blanket Additional Insured, Blanket Additional Insured Vendors,Primary/Non-Contributory <br /> General Liability Form CGD458 0219 Provide Blanket Waiver of Subrogation <br /> Automobile Liability Form CAT353 0215 Includes Blanket Additional Insured and Waiver of Subrogation <br /> Gamma Leasing Inc is included as named insured for Automobile policy <br /> Umbrella Liability is following form. <br /> Workers Compensation includes Form WC00031300-001 Blanket Waiver of Subrogation <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 Information Technologies <br /> 131 West Margaret Lane#300 <br /> Hillsborough, NC 27278 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 />