2011-367 ED - Rogers Cattle Company, Inc. for PFAP facility use

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t``CC)Ra CERTIFICATE OF LIABILITY INSURANCE DATE 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 CO TACT Donna Bowman CMS Insurance & Financial PHONE (336)679-8816 Iff (336)674-7026 201 N. State Street ADDRESS:donna.bowman0cma-insurance.com PO BOX 1456 INSURERS AFFORDING COVERAGE NAIC# Yadkinville NC 27055 INSURER A:Everett Cash Mutual Insurance INSURED INSURER B; Rogers Cattle Company LLC INSURER C: Johnny R & Sharon B Rogers INSURER D: 945 Woodsdale Road INSURER E: Roxboro NC 27574 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1111802828 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. rA TYPE OF INSURANCE D� POLICY NUMBER MO IC YEYYY MIDDY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE RENTED $ X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) CLAIMS-MADE XOCCUR X F0812199 /22/2011 /22/2012 M ED EXP(Any one person) $ 2,000 X PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN N TORY LIMITS ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? [— NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,H more space is required) Piedmont Food & Ag Processing Center is an additional insured under the General Liability coverage if required by written contract. CERTIFICATE HOLDER CANCELLATION PFAP@co.orange.nc.us SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Piedmont Food & Ag Processing Center ACCORDANCE WITH THE POLICY PROVISIONS. 500 Valley Forge Rd. Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE Russell Crissman/RIM ACORD 25(2010105) O 1988-2010 ACORD CORPORATION. All rights reserved. INS025 igninns)ni Thn Af nPn nnma=net lnnn nro ranicfarcrl marirc of/1f`npn