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_ 25
<br /> DATE(N}MlDDIYYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE FDATE
<br /> 024
<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($).
<br /> PRODUCER CONTACT
<br /> NAME: Denise Reynolds,CBIA
<br /> Marsh&McLennan Agency LLC PHONE FAx
<br /> 3625 N.Elm Street A N E •704-973-2175 A c No:336 348-1397
<br /> Suite 200 n-DO EMAIL
<br /> Denise.Reynolds@MarshMMA.com
<br /> Greensboro NC 27455 INSURERS AFFORDING COVERAGE NAIL F
<br /> INSURER A;Selective Insurance Company of America 12572
<br /> INSURED LOMAXCONS-INSURER B.-Evanston Insurance Company 35378
<br /> Lomax Construction, Inc.
<br /> P.O. Box 35169 INSURER C;
<br /> Greensboro NC 27455 INSURERD:
<br /> INSURER E-
<br /> INSURER F;
<br /> COVERAGES CERTIFICATE NUMBER:2058030384 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 70 ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> INSR AOAL FU5R POLICY EFF POLICY EXP
<br /> LTR TYPE OF INSURANCE INSD WVID POLICY NUMBER MM/Do MMfo LIMITS
<br /> A X COMMERCIAL GENERAL LIABILITY Y Y S2407234 1/1/2024 1012025 EACHOCCURRENCE 51,000,000
<br /> CLAIM&MADE �OCCUR PREMISES .occurrence) S 5D0,000
<br /> MEO EXP(Anyone person) $15,000
<br /> PERSONAL&ADVINJURY $1,000,000
<br /> GEN-LAGGREGATEJMIT APPLIES PER: GENERALAGGREGATE $3,000,000
<br /> POLICY❑ PRO LOC
<br /> JECT PRODUCTS-COMPIOPAGG $3,000,000
<br /> OTHER: $
<br /> A AUTOMOBILELIABILnY Y Y S2407234 1/1/2024 1I112025 CDMBTNEDS€NGLELIMIT $1,000,000
<br /> Ea aecfdent
<br /> X ANY AUTO BODILY INJURY(Per person) S
<br /> OWNED SCHEDULE➢ BODILY INJURY(Per accident) $
<br /> AUTOS ONLY AUTOS
<br /> HIRED NON-OWNED PROPERTY DAMAGE $
<br /> AUTOS ONLY AUTOS ONLY Pera��dent
<br /> Is
<br /> A X UMBRELLALIAB HX OCCUR Y Y $2407234 1/1/2024 1/1/2025 EACHOCCURRENCE S10,000,000
<br /> EXCESS LIA6 CLAIMS-MADE AGGREGATE $10,000,000
<br /> DED X RETENTION$0 1 1 S
<br /> A WORKERS COMPENSATION Y WC9070977 ' 11,12024 1/1,2025 X 3 ATL71'E 11RH-
<br /> AND EMPLOYERS'LIABILITY Y 1 N ^^^^
<br /> ANYPROPRIETC)WPARTNERIEXECUTNE E.LEACHACCIDENT $1,000,000
<br /> OFFICER/MEMBEREXCLUAED7 MIA
<br /> (Mandatory In NH) E.L DISEASE-EA EMPLOYEE $1,000,000
<br /> If yes,describe under
<br /> OESCRIPTIONOF OPERATIONS below E.L DISEASE-POLICY LIMIT s1,000,00D
<br /> A Builders Risk S2407233 V112024 1/1/2025 Single Location $5,000,000
<br /> A LeasedrRented Equipment 52407234 111l202Q 1/1/2025 LIMI $100,000
<br /> B Prof/Poll Liability MMAENV003822 7/8/2023 7/8/2025 Per Oourrence S3M!$3M
<br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES(AGORA 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> Project: Efiand Cheeks Elementary School-General Renovations
<br /> Orange County Board of Education is included as additional insured on a primary and non-contributory basis with respect to General Liability,Automobile
<br /> Liability and Umbrella Liability as required by written contract Waiver of subrogation in favor of Orange County Board of Education with respect to General
<br /> Liability,Automobile Liability,Umbrella Liability and Workers Compensation as required by written contract-Waiver of subrogation in favor of Orange County
<br /> Board of Education applies toward builders Risk when required by written contract.30 day notice of cancellation to be provided to certificate holder,exceptfor
<br /> non-payment of premium which is 10 days.
<br /> CERTIFICATE HOLDER CANCEI- ATION
<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 Board of Education
<br /> 2Do East King Street AUTHOR€ZEDREPRESSEEN�TAA,TIVE
<br /> Hillsborough NC 27278 � ,,,
<br /> O 1988-2015 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD
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