HomeMy WebLinkAbout2019-648-E AMS - Sasser Companies Inc DSS Hillsborough Commons Atrium remediation DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
NORTH CAROLINA CONSTRUCTION SERVICES
AGREEMENT UNDER$50,000
ORANGE COUNTY
THIS CONSTRUCTION AGREEMENT (hereinafter "Agreement"), is made and entered
into this 30th day of September, 2019 by and between Orange County, North Carolina
(hereinafter the "County" and/or "Owner") parry of the first part; and Sasser Companies, Inc.
(hereinafter the "Contractor"),party of the second part;
WITNESSETH:
For the purpose and subject to the terms and conditions hereinafter set forth, the Owner
hereby contracts for the construction services of the Contractor, and the Contractor agrees to
provide the construction services to the Owner in accordance with the terms of this Agreement.
1. TERM AND MAXIMUM AMOUNT PAYABLE
Beginning and ending dates of contract: September 30, 2019 through December 31, 2019.
The Project Commencement Date shall be September 30, 2019. Dollar Amount Not to Exceed:
Eleven Thousand Seventy Dollars ($11,070.00)
2. SERVICES
Contractor agrees to provide the following construction services (the "Work"): The work to
be preformed: Containment, Demolition, and Remediation for the Atrium at the Orange County
Department of Social Services at Hillsborough Commons. *Two air scrubers are currently within
the contained atrium area. Billing will pick up from August 28, 2019, where it was left off on the
original proposal dated August 23, 2019 *A frame will be constructed around the affected area of
the atrium, constructed of wood (2x4's), PVC, or metal pipe, wrapped in 6-mil oly to form a
containment box or chamber. A heavy, reinforced zipper will be placed for access to the
chamber. Exact dimensions wil be determined prior to the start of the project but roughly
22'x22'x8'. *One of the two air scrubers will be placed within the containment chamber, set up
under negative pressure during the demolition phase of the project. The second air scrubber will
remain on the exterior of the containment chamber to continously clean/scrub the air within the
atrium, serve as a secondary precaution in the event of an accidental spore release, ensuring that
there remains the efficiency of the suggested 4 to 6 air changes per hour, ultimately ensuring the
indoor air quality within the atrium remains at acceptable levels. *Demolition and Disposal will
consist of the following:-Removal and disposal of the wooden wall/ 3' wall. -Removal and
disposal of all books and toys (cost of replacement would be cheaper than the cost to remediate
per the standards of the IICRC's S520) except for the following: 1) Plastic Playhouse 2) Plastic
Play Tunnel 3) Plastic Play Bridge 4) Plastic Rabbit 5) Plastic Turtle. Removal of the built-up
section in this area, (storage area). Everything will be removed to the point of a bare floor except
for the plastic playhouse, plastic tunnel, plastic play bridge, plastic turtle, and plastic rabbit. The
above-mentioned items will be cleaned and left within the containment for testing unless Orange
County would rather have them removed.(There is not a price difference between the cleaning or
disposing of those items). -VCT floor tile within the containment chamber will be addressed as
follows: *Tiles that are coming up will be removed and discarded. *Tiles that require minor
scraping will be removed and discarded. *Tiles that require more aggressive methods for
removal due to properly holding mastic, will be addressed in the repair phase, which is not
currently being quoted. * At the completion of the demolition, the air scrubber within the
Revised 12/18 1
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
containment area will be placed back under neutral pressure. All floors/walls of the
containment/ceiling of the containment will be HEPA sandwiched or heavy HEPA vacuumed,
damp wiped with an approved antimicrobial, and followed up with a light HEPA vacuuming.
Both air scrubbers will be shut down in accordance with the manufacturers' specifications to
avoid accidental puffbacks. * Filters within both air scrubbers will be changed. * The entire
containment chamber will be ULV or ultra-low volume fogged wih an approved antimicrobial.
The entire atrium area will also be ULV fogged to treat the air within the area. *Air scrubbers
will be placed back in the on and neutral position, remain running and undisturbed, in the sealed
containment chamber, for the required 48-hour period, awaiting the Post Remediation
Verification from the Environmental Solutions Group.
Contractor shall not sub-contract all or any part of the construction services provided for in
this Agreement without prior written approval of the Owner. Contractor shall be responsible for
all errors or omissions, in the performance of the Agreement. Contractor shall correct any and all
errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to
Owner. Contractor is solely responsible for obtaining all permits necessary to complete the
Work in compliance with local, state, and/or federal law. The Contractor is responsible for all
physical damage to owned or rented machinery, tools, equipment, forms, and other items owned,
rented or used by the Contractor and/or Subcontractor(s) in the performance of the Work
including all of Owner's property in Contractor's care, custody, or control, and all such property
while it is in transit.
3. PAYMENT
Contractor shall submit an invoice for construction services provided. The invoice shall
contain Contractor's name and federal tax identification number and shall be signed and dated by
an officer of Contractor. It shall detail all construction services provided in payment requests.
The Owner will make payments to Contractor within thirty (30) days after receipt of and
approval of the invoice by the contracting department.
In the event the amount stated on an invoice is disputed by Owner, then Owner may
withhold payment of all or a portion of the amount stated on an invoice until the parties resolve
the dispute. In addition, should Contractor fail to perform its duties under the terms of this
Agreement, Owner may, without fault or penalty, withhold any payment associated with the
Work to be performed until such time as said work is completed.
4. RELATIONSHIP OF PARTIES
Contractor is an independent contractor of the Owner. Contractor represents that it has or will
secure, at its own expense, all personnel required in performing the construction services under
this Agreement. Such personnel shall not be employees of or have any contractual relationship
with the Owner. All personnel engaged in work under this Agreement shall be fully qualified
and shall be authorized or permitted under state and local law to perform such construction
services. It is further agreed that Contractor will obey all State and Federal statutes, rules and
regulations which are applicable to provisions of the construction services called for herein.
Neither Contractor nor any employee of the Contractor shall be deemed an officer, employee or
agent of the Owner.
Revised 12/18 2
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
5. SUSPENSION AND TERMINATION
This Agreement may be terminated by Contractor upon thirty (30) days' written notice to the
Owner, and the Owner may terminate this Agreement upon thirty (30) days' written notice to
Contractor. Owner may suspend the Work at any time for Owner's convenience and without
penalty to Owner upon three (3) days' notice to Contractor. Upon any suspension by Owner
Contractor shall discontinue the Work and shall not resume the Work until notified to proceed by
Owner. The notice required by this section or any other notice shall be delivered via certified
mail, return receipt requested to the parties at the addresses as shown on the signature page to
this Agreement. Such notice is deemed given upon its delivery to, or deposit in a receptacle of,
the United States Post Office.
6. INSURANCE REQUIREMENTS
Contractor shall obtain, at its sole expense, Commercial General Liability Insurance,
Automobile Insurance, Workers' Compensation Insurance, and any additional insurance as may
be required by Owner's Risk Manager as such insurance requirements are described in the
Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage
Requirements (each document is incorporated herein by reference and may be viewed at
http://www.oran eg counl3Mc. og v/departments/purchasing division/contracts.ph If Owner's Risk
Manager determines additional insurance coverage is required such additional insurance shall be
designated here N/A (if no additional insurance required mark N/A as being not applicable).
Contractor shall not commence construction work until such insurance is in effect and
certification thereof has been received by the Owner's Risk Manager.
7. INDEMNIFICATION
Contractor agrees, without limitation, to defend, indemnify, save, and protect Owner and
Owner's lender, if any, harmless from and against any and all claims, liens, liabilities, losses,
damages, causes of action, and expenses (including court costs and reasonable attorney's fees
related thereto) arising out of, in connection with, or resulting from any negligence, act or failure
to act by the Contractor, the Contractor's agents, assigns or employees resulting in property
damage or personal injury, including death, or other loss related to the Work. Contractor is
responsible for all errors or omissions caused by its agents, contractors, employees, or assigns in
the performance of this Agreement. It is the intent of this section to require Contractor to
indemnify the Owner to the full extent permitted under North Carolina law.
8. NON-ASSIGNMENT AND OWNER'S REPRESENTATIVE
Contractor shall not assign all or any part of this Agreement, including rights to payments, to
any other party without the prior written consent of the Owner.
The County has designated(Angel Barnes)to act as the County's representative with respect
to the Work and shall have the authority to render decisions within guidelines established by the
County Manager and/or the County Board of Commissioners and shall be available during
working hours as often as may be reasonably required to render decisions and to furnish
information.
9. NON—APPROPRIATION
Contractor acknowledges that Owner is a governmental entity, and the validity of this
Agreement is based upon the availability of public funding under the authority of its statutory
mandate. In the event that public funds are unavailable and not appropriated for the performance
Revised 12/18 3
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
of Owner's obligations under this Agreement, then this Agreement shall automatically expire
without penalty to Owner immediately upon written notice to Contractor of the unavailability and
non-appropriation of public funds. It is expressly agreed that Owner shall not activate this non-
appropriation provision for its convenience or to circumvent the requirements of this Agreement,
but only as an emergency fiscal measure during a substantial fiscal crisis.
In the event of a change in the Owner's statutory authority, mandate and/or mandated
functions, by state and/or federal legislative or regulatory action, which adversely affects
Owner's authority to continue its obligations under this Agreement, then this Agreement shall
automatically terminate without penalty to Owner upon written notice to Contractor of such
limitation or change in Owner's legal authority.
10. DISPUTE RESOLUTION
Any dispute with respect to any provision of, or the performance or non-performance of, this
Agreement shall be subject to the Dispute Resolution Rules and Procedures for Orange County
Design, Building Construction, Renovation, and Repair Projects. The policy is incorporated
herein by reference and may be viewed at
http://www.oran e�tync. o�partments/purchasing division/contracts.php).
11. ENTIRE AGREEMENT
The parties have read this Agreement and agree to be bound by all of its terms, and further
agree that it, together with specifically referenced documents, constitutes the complete and
exclusive statement of the Agreement between the parties unless and until modified by a written
amendment to this Agreement signed by the parties. Modifications may be evidenced by
telefacsimile signatures. Should any conflict arise in the terms of any documents referenced
herein and this Agreement the terms of this Agreement shall be given priority and shall control
over all other such documents. Should a request for proposals and a proposal be referenced the
terms of the request for proposals shall have priority over the terms of the proposal.
12. COMPLIANCE WITH LAW/GOVERNING LAW
Both parties agree that this Agreement shall be governed by the laws of the State of North
Carolina and any action brought under this Agreement shall be brought in the General Court of
Justice of the State of North Carolina in Orange County. Contractor shall at all times remain in
compliance with all applicable local, state, and federal laws, rules, and regulations including but
not limited to all state and federal non-discrimination laws, policies, rules, and regulations and
the Orange County Non-Discrimination Policy and Orange County Living Wage Policy(each
policy is incorporated herein by reference and may be viewed at
http://www.oran ec�ounl nc. ov�/departments/purchasing division/contracts.php). Any violation
of the Orange County Non-Discrimination Policy is a breach of this Agreement and County may
immediately terminate this Agreement without further obligation on the part of the County. This
paragraph is not intended to limit and does not limit the definition of breach to discrimination.
By executing this Agreement Contractor affirms that Contractor and any subcontractors of
Contractor are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina
General Statutes. By executing this Agreement Contractor certifies that Contractor has not been
identified, and has not utilized the services of any agent or subcontractor identified, on the lists
created by the State Treasurer pursuant to G.S. 147-86.58 and G.S. 147-86.81. This Agreement
together with any amendments or modifications may be executed electronically. All electronic
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DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and
intent of the Parties to comply with Article 11 A and Article 40 of North Carolina General Statute
Chapter 66.
IN WITNESS WHEREOF Orange County and the Contractor have signed this agreement,
effective as of the day and date first above written.
ORANGE COUNTY CONTRACTOR
9/24 2019
By[]akkit �auuwtv'� 9/24/2019 By[r�w$assu^ /
CountyRManager Kevin Sasser, Owner
200 S. Cameron St. Sasser Companies, Inc.
P.O. Box 8181 PO Box 10
Hillsborough,NC 27278 Whitsett,NC 27377
Revised 12/18 5
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
S2
riser
Sasser Companies
Restoration &Remediation Specialists
7237 Pace Drive
Whitsett,NC 27377
Phone: 336-449-1144
Fax: 336-449-1151
Member Restoration Industry Association
IICRC Certified Firm
Proposal
Prepared for:
Orange County Department of Social Services
113 Mayo Street
Hillsborough,NC 27278
Phone: (336)449-1144 PO Box 10,Whitsett,NC 27377 Fax: (336)449-1151
www.SASSERCOMPANIES.com
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
S2riser
=—AdPZAI7ffM
17 September 2019
Attention: Mrs. Angel Barnes &Mrs. Alisa Cornetto
Re: Containment, Demolition, and Remediation Proposal for Atrium at Orange County
Department of Social Services Building.
Introduction•
On Tuesday 17 September 2019, Sasser Companies was requested to prepare a proposal
for the necessary containment, demolition, remediation, and post remediation verification
for the Atrium, at the Orange County Department of Social Services building, located at
113 Mayo Street, Hillsborough, NC.
Qualifications of Investigator & Report Preparer:
Joe Hedrick
Bachelors of Science Business Administration
Institute of Inspection,Cleaning&Restoration Certification(IICRC)—Registration# 150719
Applied Microbial Remediation Technician
Applied Microbial Remediation Supervisor
Odor Control Technician
Fire&Smoke Restoration Technician
Water Damage Restoration Technician
Applied Structural Drying Technician
Subfloor and Substrate Inspector
Carpet Cleaning Technician
Color Repair Technician
Upholstery and Fabric Cleaning Technician
Health and Safety Equivalent
Repair Reinstallation Technician
Trauma and Crime Scene
Master Water Restorer
Master Textile Restorer
Master Fire&Smoke Restorer
EPA/NC Certified Renovator—NC Renovator Certification#170593
8-Hour Lead Renovation,Repair&Painting Course
American Council for Accredited Certification(ACAC)—Certification# 1703006
Certified Indoor Environmentalist
South Carolina Department of Health and Environmental Control(SCDHEC)
Asbestos Inspector/Consultant-Certification#13I-01837
Asbestos Supervisor-Certification#SA-03022
North Carolina Department of Health and Human Services(NCDHHS)
Asbestos Inspector-Certification#13139
Asbestos Worker-Certification#74836
Occupational Safety and Health(OSHA)
OSHA 10 for General Industry&OSHA 10 for Construction Industry
OSHA 30
Subrogation certified—Level 1 &Level 2
Xactimate Level 1 &2/T&M Pro Certification Course
Phone: (336)449-1144 PO Box 10,Whitsett,NC 27377 Fax: (336)449-1151
www.SASSERCOMPANIES.com
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
riser
Background Information:
Sasser Companies was originally contacted on 22 August 2019 about the issues with
odor, growth and later, bacteria in the atrium area, specifically the children's play area.
Sasser Companies prepared a proposal for the setting of room (atrium) containments,
setting of air scrubbers, removal/containing/bagging/sealing out prior to removal of the
foam play mats, and the application of an antimicrobial/antibacterial agent to the affected
VCT flooring in the source area. Air scrubbers have been running continuously since this
time to keep the indoor air quality at or below the suggested levels, per the industry
standards.
Further indoor air quality sampling, in conjunction with lift sampling has been conducted
by the Environmental Solutions Group. Official results and protocols have not yet been
released however, verbal confirmation has been made by Mr. Dan Whitaker of the
Environmental Solutions Group, approving the protocol that Sasser Companies have
included within the "protocol" section of this document, for the safe and successful
containing, demolition, removal, and remediation of the affected area within the atrium
Protocol/Proposal:
Sasser Companies have consulted with Dan Whitaker of the Environmental Solutions
Group for the necessary remediation of the atrium area. With the indoor air quality being
within acceptable limits, a full-scale remediation of the atrium is not required. What is
suggested and being proposed is the following:
➢ Two air scrubbers are currently within the contained atrium area. Billing will
pick up from 28 August 2019, where it was left off on the original proposal dated
23 August 2019.
➢ A frame will be constructed around the affected area of the atrium, constructed of
wood(2x4's), PVC, or metal pipe, wrapped in 6-mil poly to form a containment
box or chamber. A heavy, reinforced zipper will be placed for access to the
chamber. Exact dimensions will be determined prior to the start of the project but
roughly 22'x22'x8'.
➢ One of the two air scrubbers will be placed within the containment chamber, set
up under negative pressure during the demolition phase of the project. The
second air scrubber will remain on the exterior of the containment chamber to
continuously clean/scrub the air within the atrium, serve as a secondary
precaution in the event of an accidental spore release, ensuring that there remains
the efficiency of the suggested 4 to 6 air changes per hour, ultimately ensuring the
indoor air quality within the atrium remains at acceptable levels.
➢ Demolition and Disposal will consist of the following:
o Removal and disposal of the wooden wall/3' wall.
Phone: (336)449-1144 PO Box 10,whitsett,NC 27377 Fax: (336)449-1151
www.SASSERCOMPANIES.com
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
as�er
o Removal and disposal of all books and toys (cost of replacement would be
cheaper than the cost to remediate per the standards of the IICRC's S520)
except for the following:
■ Plastic Playhouse
■ Plastic Play Tunnel
■ Plastic Play Bridge
■ Plastic Rabbit
■ Plastic Turtle
o Removal of the built-up section in this area, (stage area). Everything will
be removed to the point of a bare floor except for the plastic playhouse,
plastic play tunnel,plastic play bridge, plastic turtle, and plastic rabbit.
The above-mentioned items will be cleaned and left within the
containment for testing unless Orange County would rather have removed.
(There is not a price difference between the cleaning or disposing of those
items).
o VCT floor tile within the containment chamber will be addressed as
follows.
■ Tiles that are coming up will be removed and discarded.
■ Tiles that require minor scraping will be removed and discarded.
■ Tiles that require more aggressive methods for removal due to
properly holding mastic, will be addressed in the repair phase,
which is not currently being quoted.
➢ At the completion of the demolition, the air scrubber within the containment area
will be placed back under neutral pressure.
➢ All floors/walls of the containment/ceiling of the containment will be HEPA
sandwiched or heavy HEPA vacuumed, damp wiped with an approved
antimicrobial, and followed up with a light HEPA vacuuming.
➢ Both air scrubbers will be shut down in accordance with the manufacturers'
specifications to avoid accidental puffbacks.
➢ Filters within both air scrubbers will be changed.
➢ The entire containment chamber will be ULV or ultra-low volume fogged with an
approved antimicrobial. The entire atrium area will also be ULV fogged to treat
the air within the area.
➢ Air scrubbers will be placed back in the on and neutral position, remain running
and undisturbed, in the sealed containment chamber, for the required 48-hour
period, awaiting the Post Remediation Verification from the Environmental
Solutions Group.
➢ Environmental Solutions Group will conduct the Post Remediation Verification
consisting of sampling from within the chamber as well as air sampling on the
exterior of the containment, sampling the air within the contained atrium.
Sampling results must fall within the guidelines from the American Society of
Safe Engineers', which are the standards of the Environmental Solutions Group,
and are as follows:
Phone: (336)449-1144 PO Box 10,whitsett,NC 27377 Fax: (336)449-1151
www.SASSERCOMPANIES.com
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
riser
_ .
RIQCMR Post Sampling Requirements:
➢ The indoor total spore count cannot be more than 2000.
➢ No mold is allowed on any inside sample that is not on the outside sample.
➢ Any mold present inside cannot be more than half of the mold count for that same
mold on the exterior or control sample.
➢ Aspergillus/penicillium cannot exceed a total spore count of 200.
➢ No zero tolerance molds are allowed to be present in any quantity on any inside
sample. They are:
o Stachybotrys
o Fusarium
o Trichoderma
o Memnoniella
o Chaetomium
PROPOSAL:
Sasser Companies is prepared to complete all the above listed work within the "Proposal"
section which includes the extended equipment rental for the price of$119070.00.
Special Note:
The above listed price is for the items within the "Protocol/Proposal"section of
this document only. Any additional work, demolition, testing not pertaining to the
"atrium project"or outside of the post remediation verification testing for the "atrium
project'; removal of the remaining atrium VCT flooring, or replacement of any
construction related materials or personal property (books and toys), is not covered
within this proposed price.
PERSONAL PROTECTIVE EQUIPMENT
It is the responsibility of every member of the remediation team to ensure they and all
members are in the appropriate level of personal protective equipment as required by
OSHA and Sasser Companies. N-95 masks and protective gloves has been confirmed to
be adequate levels of personal protective equipment at this point per the direction of Dan
Whitaker of the Environmental Solutions Group.
Limitations
The inspection performed and proposal are specific to the moisture issues present within
the affected area of the building and the findings/recommendations from the
Environmental Solutions Group.
Phone: (336)449-1144 PO Box 10,Whitsett,NC 27377 Fax: (336)449-1151
www.SASSERCOMPANIES.com
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
riser
Sasser Companies appreciates the opportunity to have provided you with a proposal for
the above listed/requested services. Should you or anyone else have any further
questions, comments, or concerns, please contact us directly. We are happy to discuss
any further restoration or remediation that might be necessary at your property.
Respectfully Submitted,
JbA=fflMMW3—W--
Joe Hedrick
joe(c@sassercompanies.com/Cell:336-214-0673
Sasser Companies
Office:844-449-1144/Fax:336-449-1151
7237 Pace Drive I Whitsett.NC 27377
hftp://www.sassercompanies.com
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L 10 EPH B.HEDRICK
nQ BOARD CERTIFIED
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Phone: (336)449-1144 PO Box 10,Whitsett,NC 27377 Fax: (336)449-1151
www.SASSERCOMPANIES.com
DocuSign Envelope ID:60153825-B133-48F8-824D-16A4BB63929B
SASSCOM-01 DEIAKER
,d►C�►e�- CERTIFICATE OF LIABILITY INSURANCE DATE{MMI°DIYYYYJ
02107/2019
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(ies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on
this certificate does not confer rig hts to the certificate holder in lieu of such endorsements).
PRODUCER License#1000009384 Co NA TncT
Hub International Carolinas PHONE EAx
PO Box 939 Arc,No,Ft):(336)228-0541 wc,No:(868)590-4281
Burlington,NC 27216 E--MAIL
INSURERS AFFORDING COVERAGE NAICR
_ INSURER A:Selective Insurance Company of America 12572
INSURED INSURER B:Accident Fund General Insurance Company .12304
Sasser Companies Inc INSURER C:
P 0 Box 10 INSURERD:
Whitsett, NC 27377
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,
INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXPLTR L1AIrT5
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE l "I OCCUR S 2253759 0210112019 02/01/2020 DAMAGE TO RENTED $00,000
MED EXP(Any one arson s 15,000
PERSONAL&ADV INJURY 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE a 3,000,000
POLICY PE OT LOG PRODUCTS-COMPIOP AGG 3,000,000
OTHER:
A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000
x ANY AUTO S 2253759 02/01/2019 02/01/2020 BODILY INJURY Per arson
OWNED SCHEDULED
AUTOS ONLY AUTOS E BODILY INJURY Per accident
AUTOS ONLY Al]TOS ONLY Pea'.'; nt AMAGE S
S
A )C UMRRELLA UAB x OCCUR EACH OCCURRENCE 10,000,000
EXCESS UAB CLAIMS-MADE S 2253759 02(01/2019 02/01/2020 AGGREGATE 10,000,000
QED RETENTION$
13 WORKERS COMPENSATION PER 07H
AND EMPLOYERS'LIABILITY YIN WCV6139124 02101/2019 0210112020 1,000,000 �
ANY PRO PRIETORIPARTNERIEXECuI IVE ❑ NIA E.L EACH ACCIDENT $
QFFIGERIM MBER EXCLUDED? 1'000,000
andatory�n NFi] E-L DISEASE-EA EMPLOYE $
Ifyes,describe under 11000,000
DESCRIPTION OF OPERATIONS below E.L.DISEASE"-POLICY LIMIT $
I
DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
Orange County is an additional insured under the General Liability for work performed by the named insured for such additional insured,if required by
contract signed by an authorized representative of the named insured.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Orange Count THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
9 y ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 8181
Hillsborough,NC 27278
AUTHORIZED REPRESENTATIVE
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