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SPARK-2 OP ID: PB <br /> CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDIYYYY) <br /> 04/04114 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> CONTACT <br /> PRODUCER <br /> 919-772-0233 NAME: <br /> Jones Insurance Agency,Inc. 919-779-4025 PHONE FAX <br /> P O BOX 407 A/C No Ext: A/C No): <br /> Garner,NC 27529 E-MAIL <br /> Hal Averette,CIC,CWCA ADDRESS: <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURERA:Cincinnati Insurance Company 10677 <br /> INSURED Crystal Coast Investments,Inc INSURER B:Cincinnati Indemnity Company 23280 _ <br /> DBA Sparkman Construction Co INSURERC: <br /> 11224 Conley Cove Court --- <br /> Raleigh, NC 27613-6608 INSURERD: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DDIYYYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> A X COMMERCIAL GENERAL LIABILITY EPP0174723 02/27/14 02127115 DAMAGETO ENTED 500,00 <br /> PREMISES Ea occurrence $ <br /> CLAIMS-MADE 41 OCCUR MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> '.. GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> POLICY PRO- LOC $ <br /> AUTOMOBILE LIABILITY EO accidentSINGLE LIMIT $ 1,000,000 <br /> A X ANY AUTO EBA0174723 02/27114 02/27/15 BODILY INJURY(Per person) $ <br /> ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS — <br /> /� r NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Per accident <br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 <br /> A EXCESS LIAB CLAIMS-MADE EPP0174723 02/27114 02127/15 AGGREGATE $ 2,000,000 <br /> DED X RETENTION$ $ <br /> WORKERS COMPENSATION X WCSTATU- <br /> )H-R <br /> AND EMPLOYERS'LIABILITY TOR` TS <br /> YIN <br /> B ANY PROPRIETOR/PARTNER/EXECUTIVE WC1853121 02/27114 02127115 E.L.EACH ACCIDENT $ 1,000,00 <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County <br /> P O Box 8181 <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough,NC 27278 <br /> ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />