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q CERTIFICATE OF LIABILITY INSURANCE 122/2 M/DQAYYYI <br /> 05/22/2014 <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 POilcyOes)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 /> PRODUCER ONTACT <br /> Knight Insurance PHONE FAX <br /> 919-245-1020 (A/C No);919-245-1010 <br /> 110 Boone Square Street,Suite 18 EDORAI� <br /> Hillsborough,INC 27278 <br /> gs. kni htinsurance ralei hawcbc.com <br /> INSURERS AFFORDING COVERAGE NAIC <br /> INSURER A: Int@ on National Insurance Com an <br /> INSURED <br /> Bracken,Jeffrey DBA INSURER B: Northfield Insurance Company JB Tree Service INSURER C <br /> INSURER D: <br /> 741 NC HWy(8E N INSURER E: <br /> Hillsborough,NC 2728 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS 15 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 I TYPE OF INSURANCE I DL S yl) POLICY NUMBER MMIDCDIYYYY MWDD/YY LIMITS <br /> LTR <br /> GENERAL LIABILITY WS103388 07126/13 07126/14 EACH OCCURRENCE $1000000 <br /> B X COMMERCIAL GENERAL LIABILITY PRE GE.TO RENTED. s-50,000 <br /> CLAIMS-MADE a OCCUR MED EXP(Anyone person) S5 000 <br /> PERSONAL&ADV INJURY S1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> PRODUCTS-COMP/OP AGG 52,000,000 <br /> GEM_AGGa,iE(-ATE lMf ARIES PER: S <br /> X POLICY PER,(,- LOC COMBINED SINGL uMi7 <br /> AUTOMOBILE LIABILITY 720022i32193 03/23/14 09/23/14 Ea accident 750.000 <br /> BODILY INJURY(per person) 5 <br /> A ANY AUTO <br /> ALL OWNEI SCHEDU ED BODILY INJURY(Per accident) S. <br /> AUTOS x AUTOS PROPERTY DAMAGE S. <br /> NON-01A 4ED Per acciden <br /> HIRED AUTOS H AUTOS S <br /> UMBRELLA LIAB OCC R EACH OCCURRENCE $ <br /> EXCESS LIAB CLAI S-MADE AGGREGATE S <br /> S <br /> DED RETENTION$ WCSTATU- OTH- <br /> WORKERS COMPENSATION I TORY UM11 <br /> AND EMPIAYERS'LIABILITY <br /> ANY PROPRIETORIPARTNER/EXECU VE a E.L.EACH ACCIDENT $ <br /> _ <br /> OFFICERIMEMBER EXCLUDED? NIA. 'IE.L DISEASE-EA.EMPLOYE $ <br /> (Mandatory In NH) <br /> lfyyes,describe under E.L.DISEASE.-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS Gel <br /> DESCRIPTION OF OPERATIONS I LOCATIC NS I 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 /> Orange County Governmen THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> PO BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS, <br /> Hillsborough,NC 27278 <br /> AUTHORIZED JRPF1 E TATIVE <br /> rk L <br /> fl 1-988-201 0 OR ORPO TI N. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of A ORD <br />