Loading...
HomeMy WebLinkAbout2019-147-E AMS - Boomerang ES Change Request 1 DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB110FDD324 ORANGE COUNTY NORTH CAROLINA Asset Management Services Date: February 5, 2019 Project: Phillip Nick Waters Emergency Services Building Reconstruction This contract amendment is to increase the contract amount by$30,000.00 Background: In October, 2018 Boomerang Design, PA was awarded a contract to study the moisture mitigation study, research, solutions report for the Orange County Emergency Services Facility located at 510 Meadowlands Drive, Hillsborough N.C. Change Order Description: This change order is to add the design services to the existing professional services contract 1. Provide design drawings and specifications for the bidding the reconstruction work at the Emergency Services building. Change Order Line Item Cost: This contract amendment is to increase the contract amount by $30,000.00 Professional Services: $25,000 Added Professional Services:$30,000 Total Professional Services Costs: $55,000 The BOCC approved the total design budget of$55,000 on February 5, 2019. P.O. Box 8181 * 131 West Margaret Lane, 3rd Floor* Hillsborough, North Carolina 27278 Telephone:919 245-2625 Fax:919-644-3001 E-mail:AMService@orangecountync.gov DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB110FDD324 NORTH CAROLINA CONTRACT AMENDMENT ORANGE COUNTY THIS CONTRACT AMENDMENT("Amendment")is made and entered into this 6ffi day of February, 2019 by and between ORANGE COUNTY (hereinafter referred to as "County") and Boomerang Design, PA (hereinafter referred to as"Consultant"). WITNESSETH: THAT WHEREAS, the County and Consultant entered into a contract dated October 18, 2018, (hereinafter the "Original Agreement"), for the provision of consulting services for the reframing of housing program offerings to the County; and WHEREAS, the County and Consultant desire to amend the Original Agreement while keeping in effect all terms and conditions of the Original Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration of the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: 1. In order to ensure the completion of the Services identified in the term of the Original Agreement is amended to reflect an end date by which all Services shall be completed of September 30,2019. 2. Exhibit 1 to the Original Agreement is amended by adding the following tasks and services to the Services to be provided by the Consultant: Provide architectural, mechanical, electrical, and plumbing design services for the Phillip Nick Waters Emergency Services Building Remediation and Reconstruction. 3. Article 5, Section 5.1.1 is amended to reflect a maximum payable not-to-exceed amount of Fifty-Five Thousand Dollars($55,000.00). 4. Except for the changes made herein,the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event that there is a conflict between the Original Agreement and this Amendment,this Amendment shall control. IN TESTIMONY WHEREOF, this Amendment has been executed by the parties hereto, as of the date first above written. ORANGE COUNTY CRA CM. r �: 3/4/2019 at N-OAKwtr� 3/6/2019 p, + 0�. Bonn e Hammersley �AnjM Z;rawtord Easterday,AIA County Manager Principal DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB11OFDD324 Boomerang DESIGN Page 3 of 3 Letter to: J.Thompson October 17, 2018 REIMBURSABLE FEES Mileage Printing Reimbursable Expenses: Actual expenditures made by the Designer, the Designer's employees or the Designer's professional consultants in the interest of the project shall be billed at a multiple of 1.20 times the actual cost. BOOMERANG DESIGN HOURLY RATE SCHEDULE Principal/Senior Architect $175.00 per hour Architect/ Director of Interiors $150.00 per hour Project Manager $125.00 per hour Construction Administrator $115.00 per hour Project Architect/ Project Captain $100.00 per hour Senior Interior Designer $100.00 per hour Architectural Intern/ Interior Design Assistant $ 80.00 per hour Administrative $ 75.00 per hour PAYMENT Invoicing shall be monthly for the work completed to date; accounts shall be past due after thirty (30) days; one and one-half(1.5%) percent per month service fee will be added to past due accounts. Accounts will be adjusted to include legal fees for collection to the extent allowed by law if such fees become necessary. Services for professional consultants engaged for the normal structural, HVAC, plumbing and electrical engineering services at a multiple of 1.20 times the amount billed the Architect for such services. INSTRUMENTS OF SERVICE STATEMENT Drawings, reports and specifications are instruments of service and remain the property of this firm. None are to be used on other projects or extension of this project except by agreement in writing and with appropriate compensation. Sincerely, `�, AL'Or -A �l'�Ul&(Yb l 1v Angela Crawford Easterday,AIA Principal /ace Enclosure DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB110FDD324 E N G I N E E R S October 17, 2018 boomerang DESIGN 6131 Falls of Neuse Road, Suite 204 Raleigh,North Carolina 27609 Attention: Ms. Angela Crawford Easterday,AIA Principal Reference: Proposal for Engineering Services Phillip Nick Waters Orange County Emergency Services Center Exterior Walls and Roofing Systems Assessments REI Proposal No. P18RAL-149 Dear Ms. Easterday: In response to our recent discussion and site visit, we are pleased to submit this proposal for your consideration. It is our understanding that this assessment will address the Exterior Walls and Roofing Systems at the Phillip Nick Waters Orange County Emergency Services Center located at 510 Meadowlands Drive,Hillsborough,North Carolina. A summary of the work included in this proposal is as follows: I. VISUAL EVALUATION&PRELIMINARY REVIEW A. Meet with representatives of Client's onsite staff to discuss the history of moisture intrusion problems observed at the Exterior Walls. B. Review available archive/as-built building drawings for referencing building construction and details. C. Perform a visual survey of the building's Exterior Walls and Roof areas with reported moisture intrusion to document as-built conditions and identify conditions that may be contributing to reported moisture intrusion. D. Removal two areas (first floor level and second floor level) of the CMU masonry as necessary to observe the outside face of the interior wall sheathing. Removal and resetting of the CMU units will be done by a waterproofing contractor that specializes in masonry restoration. II. REPORT A. Provide a written report of observations. B. Based on conditions determined through careful review of the Exterior Wall components and Roof Systems components, an outline of necessary or desired remedial procedures will be provided. Engineering solutions for tomorrowTM Page 1 9121 Anson Way, Suite 100 reiengineers.com Raleigh, NC 27615 800.495.9028 DocuSi n Envelope ID:2EB3A06B-5524-4E21-B639-AFB11OFDD324 �.I ENGINEERS Proposal No.P18RAL-149 These services will be provided at a fixed cost of Seven Thousand Six Hundred and Eighty Dollars ($7,680.00). Additional services will be provided in accordance with our standard fee schedule(available upon request). Schedule: On-site investigation will be completed within 15 business days of notice to proceed. Report will be issued within 15 business days of investigation. If this proposal meets with your approval, please forward a design contract for review and execution. This proposal will remain firm for a period of thirty (30) days. After that time, we reserve the right to review scheduled commitments and prices. If you have any questions regarding this matter,please do not hesitate to call. Respectfully submitted, REI Engineers Bob Tomlinson,RRC,BECxP Ron McKaskel,RRO Senior Project Engineer Branch Manager Engineering solutions for tomorrow'" Page 2 9121 Anson Way, Suite 100 reiengineers.com Raleigh, NC 27615 800.495.9028 DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB11OFDD324 Progressive Design Collaborative,Ltd Pd 3101 Popicvwood Court, Suite 320 Raleigh, North Carolina 27604 919-790-9989 October 16, 2018 Ms. Angela Crawford, AIA Boomerang Design 6131 Falls of Neuse Raleigh, North Carolina 27609 Re: Orange County Emergency Services— Humidity Investigation Angie: Thank you for asking for Progressive Design Collaborative to work with you on studying the humidity issues at the existing facility. Based on our phone call this one will be hourly with a not to exceed- I am proposing the following services: Services: • Site visit by senior engineer to investigate existing conditions. 4 hours at $175/hour • Review existing drawings 4 hours at $1751hour ■ Run loads for the existing space 6 hours at $1251hour • Report of our findings and recommendations 6 hours at $1751hour • Rough construction budget with estimated construction duration 4 hours at $1751hour • Owner meeting 4 hours at $1751hour Design Fee: $4.600 If you have any questions, please give me a call. Sincerely, �S� '0 W Steve Campbell, P . PROGRESSIVE SIGN COLLABORATIVE, LTD. Attachment: PDC Hourly Rates - 7 - � 6 pdcengineers.com DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB110FDD324 70BODMEpES 4L�. sL1r- � t ACOR0. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDOIYYYY} 10r191z018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING 1NSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or he endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement,A statement on this certificate does not confer any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME* Sheila Walker BB&T Insurance Services, Inc. PHCO H a,:704481-2692 FAX LAX No: 704482-6244 5925 Carnegie Blvd Suite 400 ADDREESS: swalker@bbandt.com Charlotte, NC 28209 INSURER(S)AFFOR0INGCOVERAGE NAiCS 704 954-3000 14990 INSURER A:P""$yws"ia kat�u�Mutual roe Ina Co INSURED INSURER B: Boomerang Design PA INSURER C PO Box 2285 Shelby, NC 28151 INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. �NSR ADOLSU POLICY EFr POLICY EXP TR 'TYPE OF INSURANCE R POLICY NUMBER (MM0DIYYYY) (MM0DIYYYY) LIMITS A x COMMERCIAL GENERAL LIABILITY y BP90670238 2/11/2018 021111201 EACHOCC URRENCE $1 000 000 occuCLAIMS-MADE �OCCUR ppR IEa occurrence) s300 000 MED ExP(Any one person) $5 000 PERSONAL SADVINJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- Lj POLICY Ll ECT LOC PROpUCTS-COMPIOP AGG s2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y AU9067023$ 7J1112018 4Z1111201 CO ao!Iden SINGLE LIMIT 1,000,000 x ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ HIRED AUTOS ONLY AUTOS x AUTOS ONLY x NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY Per accident A X UMBRELLA LIAB X OCCUR Y UL9067023$ 2/11/2018 0211112019 EACH OCCURRENCE s3,000,000 EXCESS LIAR CLAIM MADE AGGREGATE s3,000,000 DEi] x RETENTION$10000 $ WORKERS COMPENSATION I PER OTH- AND EMPLOYERS'LIABILITY Y 1 N ANY PROP RIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1 E DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached tf more space is required) Certificate Holder is automatically listed as Additional Insured IF required in their written contract with the Insured.Blanket Additional Insured Endorsement applies. Project: 510 Meadowlands Assessment CERTIFICATE HOLDER CANCELLATION Orange Count Government SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough, INC 27278 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #S211866481M19444739 BW5 DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB11OFDD324 ACa� ® DATE(MM/DDNYYY) ��. CERTIFICATE OF LIABILITY INSURANCE 10/19/2018 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 be 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 endorsement(s). PRODUCER CONTACT DougFarber NAME: Insurance Management Consultants, Inc. PAHic NN Ext: (704)799-1600 AC No: (709)799-2955 P.O. Box 2490 E-MAIL ADDRESS: doug@imcipls.com INSURERS AFFORDING COVERAGE NAIC# Davidson NC 28036 INSURERA:RLI Insurance Company 13056 INSURED INSURER B Boomerang Design, P.A. INSURERC: 201 S. Washington Street INSURER D: Suite 200 INSURER E: Shelby NC 28150 INSURER F: COVERAGES CERTIFICATE NUMBER:10/31/17 PL/WC Renewals REVISION NUMBER: 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 OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGES (RENTED PREMISES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL &ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO JECT ❑ LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N❑ N/A A (Mandatory in NH) PSW0001649 10/31/2017 10/31/2018 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 A Professional Liability xDP0030633 10/31/2017 10/31/2018 Per Claim $1,000,000 Aggregate $1,0 00,0 0 0 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION jethompson@orangecountync.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. 131 West Margaret Lane,Ste 300 AUTHORIZED REPRESENTATIVE Hillsborough, NC 27278 Jeff Todd/DGF 7;LW" ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) DocuSign Envelope ID:2EKA0613-55244E21-B639-AFB11OFDD324 A ��0 CERTIFICATE OF LIABILITY INSURANCE DATE(M 02/25//2019 Y) 019 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 be 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 endorsement(s). PRODUCER CONTACT Doug Farber NAME: Insurance Management Consultants,Inc. (AHC. o Ext: (704)799-1600 ac,No: (704)799-2955 P.O.Box 2490 E-MAIL cert@imcipls.com ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# Davidson NC 28036 INSURERA: RLI Insurance Company 13056 INSURED INSURER B: Boomerang Design,P.A. INSURER C: 201 S.Washington Street INSURER D: Suite 200 INSURER E: Shelby NC 28150 INSURER F: COVERAGES CERTIFICATE NUMBER: 10/31 PL&WC Renewals REVISION NUMBER: 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 ADDLSUBR TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE CLAIMS-MADE OCCUR PREM SESO(Ea occurrence)l $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑ PRO ❑ LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANYAUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) r $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION X STATUTE EORH PER AND EMPLOYERS'LIABILITY Y/N 1 000 000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ A OFFICER/MEMBEREXCLUDED? NIA PSW0001649 10/31/2018 10/31/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ Per Claim $1,000,000 A Professional Liability RDP0034244 10/31/2018 10/31/2019 Aggrgate $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN Orange County ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 AUTHORIZED REPRESENTATIVE 131 West Margaret Lane,Ste 300 Hillsborough NC 27278 ��/✓ �s�� ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB110FDD324 page 2 of 3 E... Client#:121479 70BOOMEDES GATE(MM10O/yYYY) ACORD., CERTIFICATE OF LIABILITY INSURANCE 01/15/2019 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(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement an Ihis certlfIcate does not confer any rights to the certificate holder In IIou of such endorsement(s), PRODUCER NNA TAIT E! Charlotte Certificate Team McGriff Insurance Services ABC.NE No,E,a;704 954-3000 � No; 888-751-3197 5925 Carnegie Blvd Suite 400 E-MAIL ccertteam0mcgriff Charlotte,NC 29209 INSURER(S)RFFORi71NG COVERAGE NAIC Y 704 954-3004 14990 INSURER A:Panmylwnla Naavrnl hiuival Cae rra co INSURED — - — — -— - INSURER B: Boomerang Design PA INSURER C., PO Box 2285 INSURER D: Shelby, NC 28151 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 CONTRACTOR 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. INS TYPE OF INSURANCE DD UBR pOu Y EFF POLICY EXP LIMBS LTRINSR WVD POLICY NUMBER MMID YYY MMIttO1YVY A X COMMERCIAL GENPRAL LUIBILtTY y 1090670238 2/11/2019 02111/202C EAgCCH OCCURRENCE $1 000 000 CLAIMS-MADE L OCCUR PREM SEs 0occu ence 000,000 MED EXP(Any an person) s 5 ODO PERSONAL&ADV 1N URY $1 000 000 GEN'✓_AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000,000 PRO- POLICY❑JECT LOG PRODUCTS-COMPIOP AG s2,000,000 OTHER: $ A AUTOMOBILE LIABILITY y AU90670238 2/11/2019 021I t1202 COMBCNmeO SWGLELIMIT 1,000 OQO x ANY AUTO BODILY INJURY(Per person) $ OWNED SCAUTOS HEDULETI AUTOS ONLY BODILY INJURY{Per accidenS] $ HIRED NON-OWNED PROPERTY❑AMAGE $ X. AUTOS ONLY x AUTOS ONLY Per accoen 5 A X UMBRELLA LIAO NCLAiMS-MADE. 00CUR Y UL9067023$ 11/2019 02/11/202 EACH OCCURRENCE s3 000 000 EXCESS LIAB AGGREGATE s3,000,000 DED I I RETENTION$ WORKERS COMPENSATIbN I'ER OTH- AND EMPLOYERS'LIAaILRY CFMCERIMEMSER EXCLUpE ANY E?EIX17NE E.L.EACH ACCIDENT ❑ N 1A $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES IACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Certificate Holder is automatically listed as A Did it Iona I Insured IF required in their written contract with the Insured. Blanket Additional Insured Endorsement applies. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 20O S Caiheron St PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS. Hillsborough, NC 27278 AUTHORISED REPRESENTATIVE CP 1988-2015 ACORD CORPORATION,All rights reserved. ACORD 25(2016103) 1 of 2 The AC0RD name and logo are registered marks of ACORD 847 #S227486531M22748569 SMWA DocuSign Envelope ID:2EB3A06B-5524-4E21-B639-AFB11OFDD324 page 3 of 3 ..,.. .., ..: :... ....................:DESCRIPTIONS INS �anuedfr m Page .= -. -_____--- -_- =___ -_-- _ - Orange County is listed as Additional Insured for General Liability when required by written agreement with the insured on BP04501/06. ............. ............._..__._......._....------.......- --. ..-.. _......._.....- - ........_..._...........__......._...------ ----..._.. - _ - - - -- ----- - - ...... ................_..................-,................_._..-..._..... =.I.I. ��.�:�;;,I'Slipli-1;;l.;;ii;i_rl:l::ir::. .i.:�:-:-'.I�� .•�.�.�_.- - - SAGITTA 25.3(2016103) 2 of 2 #S227486531M22748569 84$