347-24 RFP - 2024 CDBG Responses.pdf

2 Yo ACORD Ne DATE (MIMIDDIYYYY) 12/26/2023 CERTIFICATE OF LIABILITY INSURANCE BELOW. THIS CERTIFICATE OF REPRESENTATIVE OR PRODUCER, AND 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 INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED THE CERTIFICATE HOLDER. IMPORTANT: ihe ceviificate 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, thie certificate does not confer rights to the certificate holder in lieu of such endorsement(s)- certain policies may require an endorsement. A statement on PRODUCER Greyling Ins. Brokerage/EPIC 3780 Mansell Rd. Ste. 370 fale" Rebecca Egan PHONE No, Ext): 770-552-225 [x (AIC, No): Alpharetta GA 30022 | Kduness: greylingcerts@greyling.com INSURER(S) AFFORDING COVERAGE NAIC a wnsuner a: Markel American Insurance Company 28932 INSURED J H2MARCH w.cyper a: Hartford Underwriters Insurance Company 30104 LEN Are ees + Epeeet insurer c: Sentinel Insurance Company, Ltd. 41000 Melville, NY 11747 insurer D : Hartford Casualty Insurance Company 209424 | INSURER : INSURER: COVERAGES CERTIFICATE NUMBER: 1072411515 REVISION NUMBER: 24-25 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. T (ADI ICY EFF OLICYEXP | Me ‘TYPE OF INSURANCE usp | wp. POLICY NUMBER. _Taaiosnren | (aM) Limits B | X | COMMERCIAL GENERAL LIABILITY 2OUUGAUS233 | 112024 | 1/1/2028 | EACHOCCURRENCE $1,000,000 TX] [DAMAGE TORENTED . |__| ctams-mave | % | occur PREMISES (Ea occurrence) _| $ 1, 0 == | \ | MED EXP (Any one person) _| $ 10,000 { a | | PERSONAL ADV INJURY _| $1,000,000 GEN, AGGREGATE LIMIT APPLIES PER: ] GENERAL AGGREGATE $2,000,000 + | poucy |X ] FBO: [X] Loc | | | PRODUCTS - COMP/OP

\ | MED EXP (Any one person) _| $ 10,000 { a | | PERSONAL ADV INJURY _| $1,000,000 GEN, AGGREGATE LIMIT APPLIES PER: ] GENERAL AGGREGATE $2,000,000 + | poucy |X ] FBO: [X] Loc | | | PRODUCTS - COMP/OP AGG | $2,000,000 OTHER: $ © | AUTOMOBILE LIABILITY | ‘20UEGAU789S Giieoza | 11/2025 | GOMBNEDSINGLETINIT | $1,000,000 | (Ea accident) X | ANY AUTO BODILY INJURY (Per person) | $ OWNED. [| SCHEDULED Boni CL] SHRED wy | S52 | | BODILY INJURY (Por accident] $ X | HIRED X | NON-OWNED PROPERTY DAMAGE 3 | AUTOS ONLY | AUTOS ONLY | | | Lace $ D |X UMBRELLALIAB | X | occuR | 2OXHGYH2145 11112024 41/2025 | EACHOCCURRENCE $5,000,000 EXCESS LIAB CLAIMS: MADE! AGGREGATE $ 5,000,000 [Loe |X | retentions 19 900 | | s D WORKERS COMPENSATION QOWBGATS265 ymona | ana02s IX | any rohay "AND EMPLOYERS’ LIABILITY stil ais | Som oa [Eifrure |__| er _ ANYPROPSIETORPARTNEUEXECUTIVE nal | E.L EACH ACCIDENT $1,000,000 (Mandatory in NH) | EL DISEASE - EA EMPLOYEE, $ 1,000,000 Ityes, describe under | aes — BESGRIPTON. OF OPERATIONS below | EL DISEASE - POLICY LIMIT | $ 1,000,000 ‘A _| Professional Liability | MKLM7PL0002521 42024 | 1/1/2025 fof Ea ea | | DESCRIPTION OF OPERATIONS /LOGATIONS/ VEHIGLES (ACORD 101, Additional Remarks Schedule, may be attached more space is required) CERTIFICATE HOLDER CANCELLATION For Proposal Purposes, , only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. "AUTHORIZED REPRESENTATIVE isiaas BR hehenl ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD