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DocuSign Envelope ID:67835F96-OD2E-4C6F-9OA5-F850121 B91 CF <br /> NORTH CAROLINA FARM BUREAU MUTUAL INSURANCE COMPANY, INC. <br /> CERTIFICATE OF LIABILITY INSURANCE _ <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 <br /> to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to <br /> the certificate holder in lieu of such endorsement(s). <br /> INSURED NELSON ALARMS INC. CER'TIFICA'TE ORANGE COUNTY <br /> NAME AND PO BOX 10 HOLDER PO BOX 81881 <br /> ADDRESS RANDLEMAN, NC 27317 HILLSBOROUGH, NC 27278 <br /> COVERAGES - - -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 /> x TYPE OF INSURANCE ADDLSUSR POLICYNUMSER POUCYEFF POLICY EXP LIMITS <br /> MMIDDIWY MMIODIYYY <br /> ® COMMERCIAL GENERAL LIABILITY SMP 0113241 5/26/2015 5/26/2016 GENERAL AGGREGATE $10001000 <br /> -OCCURRENCE PRODUCTS-COMPIOPS <br /> AGGREGATE $1,000,000 <br /> GEN'L.AGGREGATE APPLIES PER POLICY PERSONAL&ADV INJURY $1,000,000 <br /> EACH OCCURRENCE $1,000,000 _ <br /> DAMAOETORENTED $100 000 <br /> PRE 1S fa„ __. <br /> MED EXP(Anyone Person) $5,000 <br /> ❑ _BUSfNESSOWNERS EACH OCCURRENCE $ <br /> AGGREGATE $ -•--- <br /> UTOMOBILELIABILITY (Each LEL.IPA11 $ <br /> (Each accident) <br /> SCHEDULEDAUTOS BODILY INJURY(Per person) $ <br /> ❑ HIREDAU'TOS BODILY INJURY(Per accident) $ _ <br /> ❑ NON-OWNED AUTOS PROPERTYDAMAGE $ <br /> ❑ GARAGE LIABILITY <br /> ❑ (Other) <br /> E] EXCESS LIABILITY— -- - EACH OCCURRENCE $ <br /> OCCURRENCE AGGREGATE $ <br /> ® WORKERS COMPENSATION NIA WCSTATUTORY[.1MfTS <br /> AND EMPLOYERS'LIABILITY WC 0213731 6121/2015 6/21/2016 EL EACH ACCIDENT $100,000 <br /> POLICY APPLIES TO THE WORKERS E L DISEASE-EA EMPLOYEE $100,000 <br /> COMPENSATION LAW IN THE STATE OF NO EL DISEASE-POLICY LIMIT $500,000 <br /> OTHER: <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES: <br /> CANCELLATION — -' - —�— — <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED AUTHORIZED REPRESENTATIVE <br /> BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, DATE 8/2 712 01 5Q� <br /> COI 0910 <br />