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DocuSign Envelope ID: FF6CCA42-9778-4C65-87A0-68F6BE066202 <br /> OP ID: TD <br /> C°R° CERTIFICATE OF LIABILITY INSURANCE DAT11204115 I <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 pollcy(les) 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 Ileu of such endorsement(s). <br /> PRODUCER 919-828-4354 CONTACT <br /> BRADSHER&BUNN INSURANCE NAME; <br /> AGENCY,INC. 919.828-6182 (AJCNNo,ExtI: FAX No): <br /> P 0 BOX 30247 727 W MORGAN ST E-MAIL <br /> RALEIGH,NC 27622 ADDRESS: -_ <br /> Charles Bradsher Jr PRODUCER ID n:NATUSTO <br /> INSURER(S)AFFORDING COVERAGE NAIC E <br /> INSURED NATURAL STONE INSTALLATION INSURERA:ERIE INSURANCE COMPANY <br /> ALLEN BROOKS BURLESON DBA INSURER B; <br /> 1425 GRECIAN WOODS LN <br /> RALEIGH, NC 27606-2584 INSURER C: <br /> INSURER D: <br /> INSURER E: <br /> 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 /> ILTR TYPE OF INSURANCE IINSR WVD POLICY NUMBER IMMIODmYY1 (MMIDOIYYYYI LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 500,000 <br /> 06!01!15 06/01/16 -D�fal t To RENTED 500,000 <br /> A X COMMERCIAL GENERAL LIABILITY Q30-0120616 PREMISES(Ea occurrence) $ <br /> CLAIMS-MADE X OCCUR MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 500,000 <br /> _._ GENERAL AGGREGATE $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO 5 1,000,000 <br /> PRO- <br /> POLICY I JECT I LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accidenp <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED AUTOS <br /> - BODILY INJURY(Per axdenl( S <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> HIRED AUTOS <br /> (Per accident) <br /> NON-OWNED AUTOS <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS TAB CLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION <br /> WORKERS COMPENSATION IAG STATU- OTH- <br /> AND EMPLOYERS'LIABILITY TORY LIMITS ER <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE Y I N Q90-0101139 06101/15 06/01/16 EL.EACH ACCIDENT $ 100,000 <br /> OFFICERNEMBER EXCLUDED') N 1 A <br /> (Mandatory In NH) E.L DISEASE-EA EMPLOYED S 100,D00 <br /> II es,desuibo under <br /> DESCRIPTION OF OPERATIONS below E .DISEASE•POLICY LIMIT $ 500,000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If mare space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORAN818 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County DEAPR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> itatt @orangecountynC.gov ACCORDANCE WITH THE POLICY PROVISIONS. <br /> P.O.Box 8181 <br /> Hillsboro,NC 27278 AUTHORIZED REPRESENTATIVE <br /> Charles Bradsher Jr <br /> ©1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD <br />