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ACS ~ ~E F~T~f I CAT E :t7.F ~~A~31t~;TT`~° ~1 ~4 ~.t~ ~4:(~ C ~ DA7E (MMrooIVYYY)
<br />(,~~ 2/1•fi/2011
<br />THIB:CERT#FICi4TE iS fSSUED-AS A IPIATTER''OF IyFOf~AAdTIt3N'ONLY A~Jb:CONF~RS.NO.F'ttGIiTS' URON THE CERTIFICATE HOLDER, THIS
<br />'CERTIFICATE DOES NOT AFFIRMATNELY Aft f'tEGATIVEIY, AMENp,• EXTENR OR ALTER THE COVERAGE•'AFFORDED 9Y THE POLICIES
<br />Bl;LOW. ~t1t3. •OERTtFICA7'E DF INSURANCE •bOES NOT CONSTITUTE A 'CONTRAC`T EETtiNEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCEF2, AND THE CERTIFICATE HOLOE•R.
<br />' #MPORTANT7 If. the certificate'hold®r is an' ADDITIONAL INSORED, tha poticy(fes) must be.sndorsed. If SU6ROGATION IS WAIVEDi subject to
<br />the telTas attd cortditlons of the policy, eetfain policies may require an endorsement A statement on This certificate does not confer rights to the
<br />ceififlcate hoideritt lieu of such endorsement(s).
<br />PRODUCER c~ Aor Julie Sizemore __ _ __ _
<br />Pelztik IASil7rance & Financial Services a DNs ~ (919) 459-8000 ~ • Nay 1919) ass-aoisf __._
<br />100 Ridgevit.ew Drive E R se. j»13e. sixemor~pelnik, cdm _~.__. ~~^.~~_,
<br />Suite 100 ~~ME~~p0007S00 _`_._.._._
<br />JUDY D BROOKS CONfiRACTOR-INC.
<br />1195 REAL RD
<br />GOLDSTON ~ NC 27252-9595'
<br />rnvFRer,FS c1=1zrlFlre'rF nit
<br />THIS lS TO CERTIFY THAT THE t?OLCIES OF#NSURANCE LISTED: BELOW. HAVE BEEN 13$UED•TO THE INSUFtED•NAMEp ABOVE~OR'7H~ f?'OI:ICY'PlRIOb
<br />INp,ICATED; NOTWITIiSTANOING ANX REOUIREMENT; TERAt.DR `CONDITIbN OF ANX't:ONTIZ4C~' OR OTHER DbGUMENT t'yl'fFl RESPECT 'f0' WHtCH SiilS
<br />CERTIFICA'!l: MAY BE iSSU>=D OR MAY PERTAIN; iTIE INSURANCE AFFOf2D£b BY 'THE POI.iCtES QESCft1BE0 HEREIN I5:3UB7ECT TO AI.t TI'tE TFRMS,
<br />CEb BY PA16 CLAIMS: __.,_•
<br />EXCLU510HS AND CONDI770N6 OF SUCH POl.tClES. LIMfTS SHAWN MAY NAVE BEEN REDL~
<br />IL7R TYP60F 1NSURANOG~ POLICY NUMBER CC
<br />P Ob M~ 1,IMIT9
<br /> GENERALt.IABIt.ITY EACHOpOURRENCB a i,•Od,D.;'QUD
<br /> X CDpaMERCIAI-r3ENERN,LU+60.ATY pbRE~~~4A!iSP~ :5_..,:_._. 300~D11E1
<br />A ~CI.AIMS•MpDB ©Ot:cutt 6P600015A /18/2011 /18/20iZ AeEq~p Anyana~,~~ J S 5 000
<br /> _ PERSONAL$.AOY_INJURY.~ S 1tOD.0.,`000
<br /> -..,.. __...,.._ C3FNERAL AGGREGATE 2:, bfla:"000
<br /> GEI•iL AGGRE6ATE?L9.i1T APPLIE$PER; ROOD S-60AtRlOP.AGG.: S 2. 'OAD ~ODfl
<br /> X PO{.ICY PRO- LOC S
<br /> AUT OMOBILE LUIBB.ITY Cp1r1H11Ij:T,1 SINS-E~UMrr
<br />(Es~arddatitJ S j r QO D ~ DO D
<br />.
<br /> ~_ ANY AUTO 6DOO1
<br />4 /I8/2b11 /18/2012 BOOILYINJURY(Parpnradryt S
<br />~~
<br />A ^µ nu; oY,misl AuFbs S tKsURY INJURY (P4r+xsddw,U 5-
<br />~~
<br />
<br />R SCHEDULl:O RUTOS
<br />HIRED AUTOS ~ pROPEYiTV'AAMAGE
<br />(Per, eeGidalil) ~
<br />S - _~~,
<br /> '~ NON-OWNEp AUTOS ._.,,
<br />,..,.__,._
<br />S
<br /> _..
<br />.
<br />S
<br /> ]i; UMBRELLA UAe OCCUR EACH OCGl1RREHGE S 6t0OO~~DDQ
<br /> E%CE36 L1AH ~ CLAIMS~MAb6 M1GGREGAYE TT $ 6, DD.0~tf00•"
<br /> DEDUCTitiLE ~
<br />~
<br />- S s--.-
<br />A _
<br />% RkZE1mON S 10 DOD OP600ff15d /18/2Di1 /19/2012 ~
<br />~~~~~~ S
<br />B WbRKFRS COMPENSATION j[ WC STA'ftJ- O7H'
<br />1MLT
<br />....-.
<br /> AND 6MPLOYER3' LIABILITY
<br />ANY PROPRIEYORlPARTNFJi~XBCUTIVE YJN _.
<br />.-.
<br />E.LF.4CNAd61bENT S 1 OOD 600
<br /> bFFlCBRU.iH.iHER PaiCLUD8D7. O-
<br />(Mshdatnry Ih NHi N('F` P100p641 ~ /10)2011 '/18/2012
<br />EL gl'3EASE.'f3li EMg1,pYE
<br />. S 1 000 DOD
<br /> I~tyYees~,~daaattawwat
<br />~OESpiIPTION OP E13AYIONS below ELDISEASH:PCLICYUMR 3 1 000: 000
<br />C Motor Truck Cargo . 12].25 /1•/2oi1 /1/2oi2 W„at $2S,D00
<br />oa:uwuda $1; DOU
<br />OESCRIpTION OP OPERATIONS! LOCATIONS! VEHICLES (Alfach ACORO fat,'Atlditloitnl Rargarka•Schodulo, llmota spaeo is rogWndt
<br />{ 919) ti 61- 9 0 38 SHOULD ANY Op THE ABOVE DESCRIBED POLICIES B E CANCELLED BEFORE
<br />• TI•IR. E:,IPIR:4710N bATE THEREOF, PIDTICE Will BE QEUVERED tN
<br />aCt.+'?11.I.'t:GE WITH THE PaL1CY PROVISIONS:
<br />AUTIiGRi?li0 REPRESE.NTATHIE
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<br />1,7ulia~ Sizemore/JSZM ~="fi"t"
<br />AGORD 25 (2004/09) ©7986-2009 ACORD CORPORATION. All rights reserved.
<br />,.,~R..~ ,...._,....,, 'r1.e er_naFl narno anti Innn era ranicterad marks of ACORD
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