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DocuSign Envelope ID: 36E6A8AF-COF9-489A-B278-380FB6C91329 <br /> AC CERTIFICATE 'F LIABILITY INSURANCE ���1 <br /> 05P16N20101 5 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGIi,47 a UPON THE CERTIFICATE IHCOLDEIpt, THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY Oft NEGATIVELY AMEND, EXTEND OR ALTER THE",,, COVERAGE AFFORDED, BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A. CONTRACT SETTN Efr--N THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, <br /> IMPORTANT, If the certificate holder Is en ADDITIONAL INSUREfOa the PofICYVes)must be endor,Ied. If SUABRCOGATICON IS WAIVE susubje t to, <br /> the terms anti'conditions Of the Policy,certain POIICIOS ERIN retNtllre can endorsement,. A statement{)rl this Certificate does not confer rights to the <br /> cOrtfiTCete holder In HOU Of such endorsement s <br /> PRODUCER —CONTACT <br /> P ... _.... _u. _ <br /> PHONE JOHN ABRAM,UR. E-NwAII <br /> 2000.101 BEARCAT"WAS ..._ .�. __ __.-_.._�. mw_,_.. - <br /> NC 275'60 mgRSUraFR a NATICNwVDEkUTUAIU FIENnE qe mwlnc <br /> NAiCIETNVNLL .._.u ,mm .. _. ...... �. <br /> ��.. LANCE.CCON,II�� � 2779m.. <br /> ITIT_._ LAITY`MUTOAL INSURANCE COMPANY <br /> �N+I50REmt0 LIRE,_... ....... .J. � __.� .w,...-�. _..�. ...... �__ <br /> INmSINiIRER C <br /> CONCRETE ALTERATIONS,LLC, INSU ne. _.. __ .. ... <br /> 2,700 GATEWAY CENTRE BLVD STE 6.50 mm' <br /> INS4DNiER a <br /> COVERAGES NdICORRIS"VIILLLE NC 275601-6215 I <br /> CERTIFICATE NUMBER: r REVISION NUMBER:IS CT THAT THE BELOW ISSUED TO THE NNIfI& U E1 ABOVE ' ' 'RIIC'D INDICA ED NOTWITHSTANDING REQUIREMENT, OR CONDITION OF ANY CONTRACT OR,OTMJER DO RESPECT TO WHICH THS STNF LATE MAY BE ISSUED OF MAY PERTAIN, THE INSURANCE AFFORDEO BY THE POLICIES DESCIIIBED HEREIN IS SUBJECT TO,ALL THE TERMS,NS AND CONDITIONS OF POLICIES,Ivd _ �. _._._�,wm <br /> LIMITS SHOWN MAY HAVE BEEN REDUCED BY RAID CL41MS <br /> � I`� e.... �. m�..,_.�m....�,_.�...._.,,m,.�.�., <br /> " 'F- F <br /> TYPe <br /> .tP INSURANCE PLCYeNMeER 9 'Man <br /> CC RefAIGENERAL LIAeNLITY 0 6tlMq G IEkACH CccuRROrvCE <br /> 1._0 <br /> ....CLAMS- E E 00 000 <br /> OCC JR 100 00!0 <br /> mm __. <br /> AROI CLCC 2235 x64425 0611812016 05)18/2 O16 (A am am Pm ny 6 000 <br /> RSC�NIAU,&ADV INJURY 4 E 1,0100 000 <br /> EN%AGGREGATE,LIMIT APPLIES PER DONAENAAq AqCIREGAmE � 2 000 000 <br /> ERO <br /> PCALMCY ,PI TT" w LOC CO <br /> PaR�rraLacTS_���YheIPAk7P AGG �S _2,000,000... <br /> AUTONMIOS"LIAW»hlLITY OMmer I OLE LiMI <br /> MtOML N 1,000000 <br /> IF <br /> ANY AUTO t � 1 YC;IdLYIC",IMddRW"gP�P�emr�el S <br /> A YNIiRIED AIu4I"TE'7S ..I SCI1EEbUILIF..0 e. .....,.... .. .... <br /> AUTOS AUTOS ACID BAF 2235564425 0 11620'15 05k18/r'I16,BODILY Uh!'�UURY(P*rawdenq E <br /> E GE <br /> 5 _ <br /> I AReLMA UAe E.A4,DhR QCCU»Y'&1RENIO.E 6 0 <br /> CUR U..RE __._.._. _ $ ...: 00 01 _.... . _ <br /> A E',MCC� e .m...._REOnATE 00 <br /> .. 5 000„000 <br /> IpED IREr JN»N CI:.AIN,NSMMAADE ACI�CAF'223564426 06P18,(2016 05N18Y2%T16 AO ,�..� _. .. <br /> AND EWPLOYEYER �4IABIUTY Yr N <br /> RAP✓aRRTMairwRSExECUTIVe � � EAaN An� IDENT �� 600 0CN0 <br /> NR�PNRNE,"r&O� <br /> m�PPIC U ENISEREXCLUDEI L��.J s 1 A WC 23'16056660 06N18r21015 05/1&2,T16 <br /> B <br /> ANA <br /> Wau <br /> m ry In H <br /> danSd undor E L.0SFASE EA DN N LCkYEE�E 3fN 0g0.µ.. <br /> _ <br /> taRIPTION OF OPERATIm INS E.L.LIISEASE.POLICY UM AT N 500„0010 <br /> 4' I <br /> eE RMpnON Of OPERATIONS LOCATIONS I VEHICLES IACO RO 101,Additional Remarks Schedule,may be aftachod if mairs space Is i4qufredp...... <br /> I <br /> CERTIFICATE HOLDER CANCELLATION! <br /> SHOULD ANY OF THE ABODE DESCRIBED POLICIES BE CANCELLED REFtORE <br /> THE E PWATION DATE THEREOF„ NOTICE 'ILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY'PROVISIONS, <br /> AUTHORIZED REPRESENTATIVE ',...... <br /> JOHN ABRAM,JR <br /> 11988-20114 ACCORD CORPORATION, All rights reserved. <br /> ACCORD 2S( 014101) The ACCORD name and logo are registered marks of ACC',IRD <br />