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© 1988-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORDACORD 25 (2016/03)cad5598 <br />CERTIFICATE HOLDER CANCELLATIONOrange County <br />300 West Tryon Street <br />Hillsborough, NC 27278 <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 />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) <br />04/03/2025 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT <br />AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES <br />NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED 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. If SUBROGATION IS <br />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 <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />CS&S/AFFINITY INSURANCE SERVICES INC <br />PO BOX 958489 <br />LAKE MARY, FL 32746-8989 <br />Phone - 877-724-2669 <br />Fax - 877-763-5122 <br />CONTACT <br />NAME: <br />PHONE <br />(A/C, No, Ext): <br />FAX <br />(A/C, No): <br />E-MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE NAIC # <br />INSURER A :Valley Forge Insurance Company 20508 <br />INSUREDJOSEPH K OPPERMANN-ARCHITECT P.A. <br />539 N. TRADE ST <br />WINSTON-SALEM, NC 27101 <br />INSURER B : <br />INSURER C : <br />INSURER D :Continental Casualty Company 20443 <br />INSURER E :American Casualty Company of Reading, Pennsylvania 20427 <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 INDICATED. NOTWITHSTANDING <br />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 <br />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 <br />CLAIMS. <br />INSR <br />LTR TYPE OF INSURANCE ADDL <br />INSD <br />SUBR <br />WVD POLICY NUMBER POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY)LIMITS <br />A <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS-MADE OCCUR <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO-JECT LOC <br />OTHER <br />Y Y 1078300866 03/21/2025 03/21/2026 <br />EACH OCCURRENCE <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />MED EXP (Any one person) <br />PERSONAL & ADV INJURY <br />GENERAL AGGREGATE <br />PRODUCTS - COMP/OP AGG <br />$2,000,000 <br />$1,000,000 <br />$10,000 <br />$2,000,000 <br />$4,000,000 <br />$4,000,000 <br />$ <br />A <br />AUTOMOBILE LIABILITY <br />ANY AUTO <br />OWNED AUTOS ONLYHIRED AUTOS ONLY <br />SCHEDULED AUTOS NON-OWNED AUTOS ONLY <br />Y Y 1078300866 03/21/2025 03/21/2026 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />BODILY INJURY (Per person) <br />BODILY INJURY (Per accident) <br />PROPERTY DAMAGE <br />(Per accident) <br />$1,000,000 <br />$ <br />$ <br />$ <br />$ <br />D <br />UMBRELLA LIAB OCCUR <br />EXCESS LIAB CLAIMS-MADE <br />DED RETENTION $10,000 <br />N Y 2095939160 03/21/2025 03/21/2026 <br />EACH OCCURRENCE <br />AGGREGATE <br />$1,000,000 <br />$1,000,000 <br />$ <br />E <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br /> <br />Y/N N Y 1078301483 03/21/2025 03/21/2026 <br /> PER <br />STATUTE <br />OTH- <br />ER <br />E.L. EACH ACCIDENT <br />E.L. DISEASE - EA EMPLOYEE <br />E.L. DISEASE - POLICY LIMIT <br />$100,000 <br />$100,000 <br />$500,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />Orange County, its officers, official agents and employees are added as an additional insured as provided in the blanket additional <br />insured endorsement as it pertains to work being performed by the named insured under written contract. 30 day Notice of <br />cancellation of Material applies. Waiver of subrogation applies. <br />Docusign Envelope ID: 3DD626EF-3280-4209-9EC4-CB2ED42A61FB