Agenda - 12-10-2024; 6-c - Amendment to the Network Development Agreement for Broadband Deployment with Lumos to Extend the Project Deadlines

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DocuSign Envelope ID:32FCA70E-8C9D-4D85-AOBE-B88413353B8B _ 49 AC RQ) CERTIFICATE OF LIABILITY INSURANCE F DATE(MMiDDNYYY) 0412812922 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 he 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 endorsements). PRODUCER CONTACT Marsh USA Inc. NAME: 80D East Canal St. PBC.N FAC No); Suite 900 E-MAIL Richmond,VA 23219 ADDRESS: INSURERS AFFORDING COVERAGE NAIL 0 CN134139455-GHGCas41-22 INSURER A:LM Insurance Corporation 33600 INSURED North State Communications Advanced INSURERS:Liberty Mutual Fire Insurance Company 23035 Services,LLC INSURER C:Ube Insurance Corporation 42404 4100 Mendenhall Oaks Parkway,Suite 300 INSURERD: High Point,NO 27266 INS UR ER E: INSURER F: _ COVERAGES CERTIFICATE NUMBER: CLE-006876859-01 REVISION NUMBER: 5 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 INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICYNUMBER MMIDD MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY T85-Z11-C1J42P-021 1010412021 1010412022 EACH OCCURRENCE $ 1,000,090 CLAIMS-MADE O OCCUR. AMAGISE T RENTED REMISES Eaoccurrenoe $ 1,000,000 MEA EXP(Anyone person $ 15,090 PERSONAL 2 ADV INJURY $ 1,990,909 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,900,000 X POLICY❑j�� LOC PRODUCTS-COMPIOPAGG S 2r r OTHER: 1 $ 0 AUTOMOBILE LIABILITY AS2-Z11-C1J42P-011 10!041202110104!2022 COMBINED SINGLE LIMIT g 1000,040 BOO ILY X ANY AUTO OILY INJURY(Perpersan) $ X OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Par accident) $ X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per acddent $ S X UMBRELLALIAS X OCCUR TH7-211-C1J42P-051 1010412021 10,10412022 EACH OCCURRENCE s 90,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,009,000 DED I I RETENTIONS $ A WORKERS COMPENSATION WC6-Z11-C1J42P-931 - 151—OUO22 X PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANYPROPRIETORIPAR'rNERfEXECUTIVE � 1,900,000 OFFICE RIM EMBER EXCLUDEG? lN' NIA E.L EACH ACCIDENT $ (Mandatory In NH) L.DISEASE-EA EMPLOYEE $ 1,DD0,DDD If yes,dusrdbe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMITS 1'000,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 195,Additional Remarks Schedule,may be attached If more space is required) Orange County,its departments,agents,empbyeas or assigns Islare Included as additional insured(except workers'compensation)where required by written conlract.Waiver of subrogation Is applicable where required by written contract. CERTIFICATE HOLDER CANCELLATION Orange County,North Carolina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Travis Myren THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O.Bax 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough,NO 27278 AUTHORIZED REPRESENTATIVE 7/ealzd� 'ze 15111V. Q 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD