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ANY PROPRIETOR/PARTNER/EXECUTIVEOFFICER/MEMBER EXCLUDED?
<br />INSR ADDL SUBR
<br />LTR INSD WVD
<br />PRODUCER CONTACT
<br />NAME:
<br />FAXPHONE
<br />(A/C, No):(A/C, No, Ext):
<br />E-MAIL
<br />ADDRESS:
<br />INSURER A :
<br />INSURED INSURER B :
<br />INSURER C :
<br />INSURER D :
<br />INSURER E :
<br />INSURER F :
<br />POLICY NUMBER POLICY EFF POLICY EXPTYPE OF INSURANCE LIMITS(MM/DD/YYYY)(MM/DD/YYYY)
<br />AUTOMOBILE LIABILITY
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABILITY
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
<br />AUTHORIZED REPRESENTATIVE
<br />EACH OCCURRENCE $
<br />DAMAGE TO RENTEDCLAIMS-MADE OCCUR $PREMISES (Ea occurrence)
<br />MED EXP (Any one person)$
<br />PERSONAL & ADV INJURY $
<br />GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE $
<br />PRO-POLICY LOC PRODUCTS - COMP/OP AGGJECT
<br />OTHER:$
<br />COMBINED SINGLE LIMIT $(Ea accident)
<br />ANY AUTO BODILY INJURY (Per person)$OWNED SCHEDULED BODILY INJURY (Per accident)$AUTOS ONLY AUTOS
<br />HIRED NON-OWNED PROPERTY DAMAGE $AUTOS ONLY AUTOS ONLY (Per accident)
<br />$
<br />OCCUR EACH OCCURRENCE
<br />CLAIMS-MADE AGGREGATE $
<br />DED RETENTION $
<br />PER OTH-STATUTE ER
<br />E.L. EACH ACCIDENT
<br />E.L. DISEASE - EA EMPLOYEE $If yes, describe under E.L. DISEASE - POLICY LIMITDESCRIPTION OF OPERATIONS below
<br />INSURER(S) AFFORDING COVERAGE NAIC #
<br />COMMERCIAL GENERAL LIABILITY
<br />Y / N
<br />N / A
<br />(Mandatory in NH)
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
<br />If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
<br />this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
<br />COVERAGES CERTIFICATE NUMBER:REVISION NUMBER:
<br />CERTIFICATE HOLDER CANCELLATION
<br />© 1988-2015 ACORD CORPORATION. All rights reserved.ACORD 25 (2016/03)
<br />CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
<br />$
<br />$
<br />$
<br />$
<br />$
<br />The ACORD name and logo are registered marks of ACORD
<br />6/27/2025
<br />(703) 827-2277 (703) 827-2279
<br />25674
<br />Schnabel Engineering, LLC
<br />Schnabel Engineering South, PC
<br />11-A Oak Branch Dr
<br />Greensboro, NC 27407
<br />19038
<br />24319
<br />A 1,000,000
<br />P-630-2Y493523 7/1/2025 7/1/2026 300,000
<br />5,000
<br />1,000,000
<br />2,000,000
<br />2,000,000
<br />1,000,000A
<br />810-2Y384459 7/1/2025 7/1/2026
<br />10,000,000A
<br />CUP-2Y554397 7/1/2025 7/1/2026 10,000,000
<br />10,000
<br />B
<br />UB-2Y489964 7/1/2025 7/1/2026 1,000,000
<br />N 1,000,000
<br />1,000,000
<br />C Professional Liab.03147536 7/1/2025 Per Claim 1,000,000
<br />C Professional Liab.03147536 7/1/2025 7/1/2026 Aggregate 1,000,000
<br />RE: Lake Orange Intake Tower Rehabilitation Replacement Project, Orange County, North Carolina (Schnabel Reference 24210018.00P)
<br />Orange County, its officers, agents and employees are included as additional insured with respect to General Liability, Automobile Liability and Umbrella
<br />Liability when required by written contract. General Liability, Automobile Liability and Umbrella Liability are primary and non-contributory over any existing
<br />insurance and limited to liability arising out of the operations of the named insured and when required by written contract. General Liability, Automobile
<br />Liability, Umbrella Liability and Workers Compensation policies include a waiver of subrogation in favor of the additional insureds where permissible by state
<br />law and when required by written contract. Umbrella Liability coverage sits excess over General Liability, Automobile Liability and Employers Liability
<br />SEE ATTACHED ACORD 101
<br />Orange County
<br />300 West Tryon Street
<br />P O Box 8181
<br />Hillsborough, NC 27278
<br />SCHNENG-01 KSUTTON
<br />Ames & Gough
<br />8300 Greensboro Drive
<br />Suite 980
<br />McLean, VA 22102
<br />admin@amesgough.com
<br />Travelers Property Casualty Company of America, A++, XV
<br />Travelers Casualty and Surety Company A++. XV
<br />Allied World Surplus Lines Insurance Co. A+ XV
<br />X
<br />7/1/2026
<br />X
<br />X
<br />X
<br />X
<br />X
<br />X
<br />X
<br />Docusign Envelope ID: 021C6470-B14B-4CA1-B638-425BDA523E1FDocusign Envelope ID: 64C8DD46-2EE5-445D-9F2E-C6215945E8C2
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