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DocuSign Envelope ID: FFA2C826-5690-4F42-8E6E-2ADOBE9BB131 <br /> Created on: Monday, January 26th, 2015 at 10:57AM <br /> �� � DATE(MMlDD/YYYY) <br /> " '' CERTIFICATE OF LIABILITY INSURANCE <br /> Iik -�' F01/26/2015 <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 NAAME: HIGH&RUBISH INSURANCE AGENCY <br /> HIGH & RUBISH INSURANCE AGENCY PH 0,N Et),919 FAAlXC No:919-913-1155 <br /> 6015 FARRINGTON ROAD E-MAIL <br /> ADDR SS: <br /> PO BOX 3040 PRODUCER <br /> CHAPEL HILL, NC 27515 CUSTOMER ID#7 <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: <br /> INC. INSURER B: <br /> PIEDMONT WILDLIFE CENTER, C 1 INSURER C: <br /> INSURER D: <br /> 364 LEIGH FARM ROAD INSURER E: <br /> DURHAM NC 27707 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 I TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP <br /> LTR R VVVD POLICY NUMBER MM/DDlYYYY MM/DD/YYYY LIMITS <br /> GENERAL LIABILITY NI N481625 EACH OCCURRENCE $1 000 000 <br /> A X 09/01/14 09/01/15 DAMAGE TO RENTED <br /> COMMERCIAL GENERAL LIABILITY <br /> PREMISES Ea occurrence $100,000 <br /> CLAIMS-MADE Fx�OCCUR MED EXP(Any one person) s5,000 <br /> PERSONAL&ADV INJURY $1,000,000 <br /> GENERALAGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $INCLUDED <br /> POLICY PRO- <br /> J_CT LOC I i $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO (Ea accident) <br /> BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Peraccident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> HIREDAUTOS (Per accident) $ <br /> NON-OWNED AUTOS $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE <br /> AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION WC STATUS OTH- <br /> AND EMPLOYERS'LIABILITY YIN I T <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? ❑ N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> A PROPERTY 7NN481625 0 $26,000 TIV <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> LOC: 364 LEIGH FARM RD, DURHAM, NC 27707/DED: $1,000.00/CO-INS: 80%/ACV BASIS <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> HILLSBOROUGH, NC 27278 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD <br />