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DocuSign Envelope ID:2E150770-7335-4B4E-BDA7-47D76E2FC4C6 <br /> SUMMARY OF ENDORSEMENTS <br /> APPLICABLE TO ALL COVERAGES: <br /> 1-UNAU-9537-MU-04, 11108 Business Auto Declarations <br /> IL 0017(11198) Common Policy Conditions <br /> IL 0021 (07/02) Nuclear Energy Exclusion (Broad Form) <br /> IL 00 03(09107)-Calculation of Premium <br /> STATE: NC <br /> CA 0001 (03106) Business Auto Coverage Form <br /> CA 0126(07110) North Carolina Changes <br /> CA 2048 (02199) Designated Insured <br /> Skanska Usa Building Inc; Skanska Usa Inc.And The Owner 4309 Emperor Blvd Ste 200 Durham, NC 27703-8046 <br /> CA 2116 (04110) North Carolina- Uninsured Motorist Coverage <br /> CA 2384(01106) Exclusion of Terrorism <br /> CA 9903 (03106)Auto Medical Payments Coverage <br /> CA 9910 (09102) Drive Other Car Cov-Broad Cov For Named Individuals <br /> Total Premium: $ 107 <br /> Name of Individuals: WILLIAM DICKERSON III <br /> OTC Coverage: Yes <br /> Collision Coverage: Yes <br /> CAU 014 (04104)Waiver Of Trnsfr Of Rights Of Recovery Against Others To Us <br /> Name of Person or Organization: SKANSKA USA BUILDING INC; SKANSKA USA INC. AND THE OWNER.,4309 EMPEROR BLVD., <br /> STE 200., DURHAM, NC 27703,4309 Emperor Blvd, Ste 200_, Durham, NC 27703 <br /> CAU 014(04104)Waiver Of Trnsfr Of Rights Of Recovery Against Others To Us <br /> Name of Person or Organization: BLANKET WHERE REQUIRED IN WRITTEN CONTRACT PRIOR TO LOSS <br /> CAU 058(12 09)Auto First Choice Endorsement <br /> Premium: $250 <br /> Auto First Choice Physical Damage Premium: $ 125 <br /> Auto First Choice Liability Premium: $ 125 <br /> IL 008 (11/08)-Total Lead Exclusion <br /> IL 009(11108)-Total Asbestos Exclusion <br /> VEHICLE ENDORSEMENTS <br /> Vehicle#2: 2006 FORD CAB FORW 550 BLUE DIAMOND VIN: 3FRML55ZBSV240526 <br /> CA 9944(12193) Loss Payable Clause <br /> See Schedule for Vehicle#2 <br /> Vehicle#3: 2006 GMC C4500 VIN: 1 GDE4C1276F406919 <br /> CA 9944(12193) Loss Payable Clause <br /> See Schedule for Vehicle#3 <br /> Vehicle#4: 2006 CHEVROLET KODIAK VIN: IGBE4C1276F412924 <br /> CA 9944 (12193) Loss Payable Clause <br /> See Schedule for Vehicle#4 <br /> Vehicle#9: 2011 FORD F150 VIN: 1FTFXIEFOBFA68694 <br /> CA 9944(12193) Loss Payable Clause <br /> See Schedule for Vehicle#9 <br /> Vehicle#11: 2015 CHEVROLET SILVERADO VIN: I GC1 KWEG4FF1 00809 <br /> CA 9944(12193) Loss Payable Clause <br /> 1-UNAU-9537-MU-04, 11/08 PREPARED: 10-30-2014 Page 8 of 9 <br /> Includes copyrighted material of Insurance Services Office, Inc.with its permission. <br />