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DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE
<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 be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />CONTACTPRODUCERNAME:
<br />FAXPHONE
<br />(A/C, No):(A/C, No, Ext):
<br />E-MAIL
<br />ADDRESS:
<br />PRODUCER
<br />CUSTOMER ID #:
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />INSURED INSURER A :
<br />INSURER B :
<br />INSURER C :
<br />INSURER D :
<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 />ADDL SUBRINSR POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITSPOLICY NUMBERLTR (MM/DD/YYYY) (MM/DD/YYYY)INSR WVD
<br />GENERAL LIABILITY EACH OCCURRENCE $
<br />DAMAGE TO RENTED
<br />COMMERCIAL GENERAL LIABILITY $PREMISES (Ea occurrence)
<br />CLAIMS-MADE OCCUR MED EXP (Any one person) $
<br />PERSONAL & ADV INJURY $
<br />GENERAL AGGREGATE $
<br />GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG $
<br />PRO-$POLICY LOCJECT
<br />COMBINED SINGLE LIMITAUTOMOBILE LIABILITY $(Ea accident)
<br />ANY AUTO BODILY INJURY (Per person) $
<br />ALL OWNED AUTOS BODILY INJURY (Per accident) $
<br />SCHEDULED AUTOS PROPERTY DAMAGE $(PER ACCIDENT)HIRED AUTOS
<br />$NON-OWNED AUTOS
<br />$
<br />UMBRELLA LIAB EACH OCCURRENCE $OCCUR
<br />EXCESS LIAB CLAIMS-MADE AGGREGATE $
<br />$DEDUCTIBLE
<br />$RETENTION $
<br />WC STATU- OTH-WORKERS COMPENSATION
<br />TORY LIMITS ERAND EMPLOYERS' LIABILITY Y / N
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $N / AOFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)E.L. DISEASE - EA EMPLOYEE $
<br />If yes, describe under
<br />E.L. DISEASE - POLICY LIMIT $DESCRIPTION OF OPERATIONS below
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<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 />AUTHORIZED REPRESENTATIVE
<br />© 1988-2009 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORDACORD 25 (2009/09)
<br />Kirkland G. Brown
<br />OP ID: KB
<br />12/28/2023
<br />Kirk Brown
<br />Diversified Insurance
<br />Solutions LLC
<br />P. O. Box 15734
<br />Durham, NC 27704-
<br />Kirkland G. Brown
<br />919-471-8222 919-471-6607
<br />kbrown@diverseins.com
<br />BROWBRO
<br />Brown Brothers Plumbing and
<br />Heating Company, Inc.
<br />2820 N. Roxboro Road
<br />Durham, NC 27704
<br />Builders Premier Insurance Co.10844
<br />Builders Mutual Insurance Co.10844
<br />Hiscox Pro 44318
<br />Travelers Property/Casualty 36161
<br />1,000,000
<br />A X X PCP0000055 15 12/31/2023 12/31/2024 300,000
<br />X 10,000
<br />X contractual liab.1,000,000
<br />X Deductible $500.2,000,000
<br />2,000,000
<br />X
<br />X 1,000,000
<br />B X
<br />CAP0042875 13 12/31/2023 12/31/2024
<br />X
<br />X
<br />X
<br />X Deductible -0-
<br />X X 10,000,000
<br />10,000,000
<br />B MUB0004308 06 12/31/2023 12/31/2024
<br />X 10,000
<br />X
<br />B WCP0044355 15 12/31/2023 12/31/2024 1,000,000N
<br />1,000,000
<br />1,000,000
<br />C Pollution/Profess.ANE2266438.23 06/03/2023 06/03/2024 Occ/Aggr.2,000,000
<br />D Third Party Crime 106446766 01/20/2023 01/20/2024 2,000,000 10,000 Ded.
<br />Orange County, North Carolina is an Additional Insured, per attached forms.
<br />
<br />
<br />
<br />Email to: abarnes@orangecountync.gov
<br />ORANCO7
<br />Orange County Public Works
<br />Attn: Angel Barnes
<br />300 W Tryon St, Bldg.B, 3rd Fl
<br />P.O. Box 8181
<br />Hillsborough, NC 27278
<br />DocuSign Envelope ID: 4CE4ADAC-C388-4F40-AE24-FC9E8E50A3AB
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