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DocuSign Envelope ID: EE2AOFEC -39A2- 4424- A26B- C5C717E18747 <br />��•� MULBE -1 OP ID: NE <br />ACORL?" <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DDIYYYY) <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 />PRODUCER 919 - 913 -1144 <br />High & Rubish Insurance Agency <br />P.O. Box 3040 919- 913 -1155 <br />6015 Farrington Rd. Ste 101 <br />Chapel Hill, NC 27517 <br />Christopher Ives Rubish <br />CONTACT <br />PHONE FAX <br />A/c No Ext : A/C No): <br />E -MAIL <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A: Erie Insurance Exchange <br />26271 <br />INSURED Mulberry Building Co., LLC <br />& Mulberry Restoration Inc. <br />Peter Yeganian <br />9501 HWY 86 N <br />Cedar Grove, NC 27231 <br />INSURER B: <br />02/01/15 <br />02101114 <br />INSURER C <br />EACH OCCURRENCE <br />INSURER D: <br />PREMI TO RENTED <br />PREMI Ea occurrence <br />INSURER E: <br />MED EXP (Any one person) <br />INSURER F; <br />PERSONAL & ADV INJURY <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 <br />LTR <br />TYPE OF INSURANCE <br />DDL <br />SUER <br />POLICY NUMBER <br />MMIDDY/YYYY <br />/ DfYYYY <br />MM <br />LIMITS <br />A <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE F_x] OCCUR <br />AUTHORIZED REPRESENTATIVE <br />306 -A REVERE RD. <br />Q38- 0153893 <br />Q38 - 0153893 <br />02/01/15 <br />02101114 <br />02/01/16 <br />02/01/15 <br />EACH OCCURRENCE <br />$ 1000,00 <br />PREMI TO RENTED <br />PREMI Ea occurrence <br />1:000,00l: <br />$ <br />MED EXP (Any one person) <br />$ 5,00 <br />PERSONAL & ADV INJURY <br />$ 1,000,00 <br />GENERAL AGGREGATE <br />$ 2,000,00 <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />POLICY PRO LOC <br />JECT <br />PRODUCTS - COMP /OPAGG <br />$ 2,000,00 <br />$ <br />A <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS NON OWNED <br />HIRED AUTOS AUTOS <br />Q02- 0132026 <br />02/01/14 <br />02/01/16 <br />COMBccidINED SINGLE LIMIT <br />Ea aent <br />1,000,000 <br />$ <br />BODILY INJURY (Per person) <br />_ <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />Per accident <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETOR /PARTNER /EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? ❑ <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N / A <br />Q86- 0600694 <br />Q86- 0600694 <br />I <br />02106115 <br />02/06/14 <br />I <br />02/06/16 <br />02/06115 <br />I <br />WC STATU- OTH- <br />X TORY LIMITS ER <br />E.L. EACH ACCIDENT <br />$ 100,00 <br />E.L. DISEASE - EA EMPLOYE Id <br />$ 100,00 <br />I E.L. DISEASE - POLICY LIMIT <br />I $ 500,00 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />ORANG -1 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />ORANGE COUNTY PLANNING & <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />INSPECTIONS DEPT. <br />P O BOX 8181 <br />AUTHORIZED REPRESENTATIVE <br />306 -A REVERE RD. <br />HILLSBOROUGH, NC 27278 <br />©1988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />