Agenda - 04-04-2023; 5-b - Application for Zoning Atlas Amendment – Parcel Located at 3026 White Cross Road, Chapel Hill, in Bingham Township

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D M/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 02/17/2022 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 Kira Gibson,AINS,SBCS NAME: The Sewell Insurance Agency PHONE Ext): (910)326 5754 FA Na: (910)326 6310 785-1 W Corbett Ave E-MAIL kira@thesewellagency.com ADDRESS: PO Box 835 INSURER(S)AFFORDING COVERAGE NAIC# Swansboro NC 28584 INSURER A: Bankers Insurance Group 33162 INSURED INSURER B: Progressive Southeastern 38784 AMP'D Engineering PLLC INSURER C: NorGUARD Insurance Company 31470 PO Box 4580 INSURER D: Berkshire Hathaway GUARD Insurance Company INSURER E, Emerald Isle NC 28594 INSURER F: COVERAGES CERTIFICATE NUMBER: CL2221703839 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 MAYBE 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. ILTR INSD WVD POLICY NUMBER POLICY EFF POLICY EXP LIMITS TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 JAMAUE 1U HEN I E7-CLAIMS-MADE � OCCUR PREMISES(Ea occurrence) $ 300,000 MED EXP(Any one person) $ 10,000 A 32 0040007108 0 02 03/02/2022 03/02/2023 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY ❑ PRO- ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: Add'I for policy minimum $ AUTOMOBILE LIABILITY 00MBINED SINGLE LIMIT $ 1,000,000 (Ea accident) ANY AUTO BODILY INJURY(Per person) $ B OWNEDX SCHEDULED 01335494 11/05/2021 11/05/2022 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X PER STATUTE EORH AND EMPLOYERS'LIABILITY Y/N 500,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE N/A AMWC357500 03/01/2022 03/01/2023 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 $ Professional Liability D AMPL339476 03/01/2022 03/01/2023 Per Claim $1,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN AMP'D Engineering PLLC ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 4580 AUTHORIZED REPRESENTATIVE Emerald Isle NC 28594 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD