OTHER-2023-051 Service Contract for Short Range Transit Plan

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DocuSign Envelope ID:5278FBDE-6365-4ABB-A08F-CBB7E7FBC2B5 DATE(MM/DD/YYYY) ACORO® CERTIFICATE OF LIABILITY INSURANCEF�� 7/1/2024 10/l 0/2023 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 INSURERS), 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). CONTACT PRODUCER LOckton Companies NAME: 444 W.47th Street,Suite 900 PHONE FAX Kansas City MO 64112-1906 E-MAIL o Ext. A/C No (816)960-9000 ADDRESS: kcasu@,lockton.com 1 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Lloyds of London INSURED NELSON\NYGAARD CONSULTING ASSOCIATES,INC. INSURER B:Zurich American Insurance Company 16535 1418374 2 BRYANT STREET,SUITE 300 INSURER C:American Guarantee and Liab.Ins. Co. 26247 SAN FRANCISCO CA 94105 INSURER D:Allied World Surplus Lines Insurance Company 24319 NELSON/NYGAARD INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 19976920 REVISION NUMBER: XXXXXXX 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 EFF POLICY EXP /Y LIMITS LTR POLICY NUMBER MM/DDYYY MM/DD/YYYY B X COMMERCIAL GENERAL LIABILITY Y N GL00926401 7/1/2023 7/1/2024 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE CLAIMS-MADE X OCCUR PREM SES Ea occu ence $ 1,000,000 MED EXP(Any one person) $ 25,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑JECT PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ MINED C AUTOMOBILE LIABILITY N N BAP0926404 7/1/2023 7/1/2024 Ea acc d.r"l SINGLE LIMIT $ 1,000,000 X ANY AUTO BODILY INJURY(Per person) $ XXXXXXX OWNED AUTOS ONLY AUTOSULED BODILY INJURY(Per accident) $ XXXXXXX X HIRED TY X NON-OWNED PROPERDAMAGE $ XXXXXXX AUTOS ONLY AUTOS ONLY Per accident $ XXXxxXX UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX r_tDED RETENTION$ $ XXXXXXX WORKERS COMPENSATION Y PER OTH- B AND EMPLOYERS'LIABILITY Y/N WC0926402 7/1/2023 7/1/2024 X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1 $ 1,000,000 A PROFESSIONAL N N GLOPR2302224. 7/1/2023 7/1/2024 $1,000,000 PER CLAIM/S1,000,000 D LIABILITY 0312-4137 7/1/2023 7/1/2024 AGGREGATE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) RE:PROJECT:ORANGE COUNTY PUBLIC TRANSPORTATION SRTP 2022.0686.ORANGE COUNTY,ITS OFFICERS,OFFICIAL AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY,IF REQUIRED BY WRITTEN CONTRACT.WAIVER OF SUBROGATION IN FAVOR OF THE ADDITIONAL INSUREDS APPLIES AS RESPECTS WORKERS COMPENSATION,IF REQUIRED BY WRITTEN CONTRACT AND WHERE ALLOWED BY LAW. COVERAGE IS SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 19976920 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ORANGE COUNTY,NORTH CAROLINA ACCORDANCE WITH THE POLICY PROVISIONS. ATTN:NISHITH TRIVEDI P.O.BOX 8181 AUTHORIZED REPRESENTATIVE HILLSBOROUGH, NC 27278 ©1988'-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD