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<br /> , Acciku CERTIFICATE OF LIABILITY INS URANC E DATE(IMXIDD/s/Vra .
<br /> THIS.dpTIFICATE IS ISSUED-AS A MATTER'OF 11‘,100RMATION'ONLY A(Jb.:CONFERS.NO:TtIGIITS"WON THE CERTIFICATE HOLDER, THIS
<br /> CERTiEICATE DOES NOT AFFIRMATIVELY OK NEGATIVELY,AMENO,.-EXTEND OR ALTER THE COVERAGEAFFORDED BY THE POLICIES
<br /> BELOW. 4•HIS..DERTIFICATE OE INSLIRANCE.130ES-NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHDRIXED
<br /> • REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. - • t
<br /> ''IMPORTANT: II.the certificato•holder is an:ADDITIONAL INSURED,the polley(tes)mtist,be,endersod. I(SUBROGATION IS WAIVED,subject to
<br /> the terms and conditions of the policy,certain Pollutes may require en ondorsemenL A statement on this certificate does not corder rights to the • '',
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<br /> certificate holder Irl lieu of such ondorsement(5).
<br /> ' pea/me ER -4CirmA°T Julie Sizernote , ____-----... '':'•.
<br /> Pelnik Insurance & rinancial, SerVicps (9191459-B0So
<br /> COR....p. 0 IlaR01232)4se-eols ._ ....:,-.
<br /> 100 Ridgevi Ey Drive ,,,bmat$B,,julict,sizemoreApelni.lc,ccitn ....i
<br /> Suite 100 eruru matinee_.A0007500
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<br /> C4X7 .-„.. . NP '27511 _ , , . itoramArronDING,COVERAGE _ ? time it ,iiilj'
<br /> *illeurreir3 . INsurienAarartkenruuth. Metual
<br /> . • leausert a Abildsizs 1411.tual,Tosurartee CO- . __-
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<br /> JUDY 0 BROOICS CONTRACTOR-WO. iesueutoOsseic Er urance .Com•any.
<br /> 1195 SEAL RD . leaUFIEfie i •f'.:',
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<br /> GQLDSTON NC 27252,-9595' .• • , ' NItLIRMF I . ••••1,'
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<br /> COVERAGES . - CERTIFICATE NUNIDER;CE•11'21 61%2.13 REVISION:Ma:MEW: .' • ''‘'.4
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED:BELOW.HAVE BEEN ISSUED TO THE INSURED,NAMED MOVE-FOKTHE POLICY.PERIDD • ' WJ,
<br /> INPtCATED: NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY'CONTRACT OR OTHER DOCUMENT WITH RESPECT 10 WHICH THIS Al
<br /> CERTIFICATE MAY SE ISSUED OR MAY PERTAIN(THE INSURANCE AFFORDED by THE Rooms DESCRIBED-HEREIN 15.-SUIDECYTO ALL THE TERMS, . •;(:,,''.q
<br /> EXCLUSIONS AND CONDITIONS OF SUCH PoLICIES.LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS
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<br /> ORNERALLIADIUTY . EActi ocothitteNce s 1-;00,0:,*0?0 • :'.5,..T.:i
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<br /> 3{. commERcIALOSNERAL UMIUTY . PEllW(dascgRPOP-1--.. -..L 300 100-9
<br /> A _ , I cuwAVNADER FE-occurs atle4000154 z/leizela 2/18/2012 ma)Exe 02111,21:17.T. .L. '5 r 00B.
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<br /> - PERK/NAI.,PEW.INJURY' $ 1/09.0-1'00V -- 0
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<br /> SBNERAL.RecREGATE '$
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<br /> GE.Ift..A0DR E0ATE LIMN APp.I.IER FIrm. , . PR0OUCTS,-COMN/Op:„.1,5e.s. $ ;..,13.00;p00 .. ..4.,.,,i
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<br /> XANY AUTO ' • 4--------. . ,,,,,••,.•,k
<br /> -- BODILY INJuRY WO poicOn) S -- .,,,V,,■,I;
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<br /> A ALL,0%44E0 AUTOS ' DX 6000154 /15/2óu 1/18/2012 • . .
<br /> . aeorLy INJURY PIO PecId01)1) $-
<br /> SCHOUL01 AUTOS ..
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<br /> EXCESS LIAO ctAms,D.ot"
<br /> AGGneci-Da s 6_.,°b°*/..q.9,0:
<br /> . ,. DEDUCTIBLE S ,
<br /> A a RETENTION 5 10,000 HOP 6000154 /I0/zOti 1/10/2012
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<br /> 'PENSATION
<br /> B 1.4:177pT.A9RMR a'Li A R NJ tY YIN • .=.-I WC!rd. I OTto
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<br /> PrZZIEVAIM."""r1 N I-A , E.L.WI(AdaiDeNF a „1,00C!,00(1, ."';',1
<br /> (ANYKInlory I A NH) WDE1000641 , ' q18/2011 2/1B/2012 F-L CISF.AsA•pPLOYRE$ , 1.,000,000
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<br /> .DESCRIPTION oP_peeitAI,oNS beror . , ELOISE/WE:paid?LIMIT $ I,000:,bpi() ....,"':
<br /> c Motor Truck Caxqo .' - ass1212B c/1/2oll 3042012 u,4 $25;pbb ...'
<br /> OclucD0 01 006
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<br /> es,soritro DB OF OI,ERATIONS/i.DCATIONS/VEHICLES(AIWA ACORO 101,'AtAllila AnI Ronizok$-Selul ON.If moh,141;1W IE/091111mr0 : .Sq.
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<br /> PET?TIFICATE HOLDER _. , CANCELLATION .
<br /> .F.
<br /> (919)661-9038 . .-
<br /> - SHOLo ANY uP THE,400VE DESCRIBE'S POLICIES BE CANCELLED BEFORE •
<br /> ' THq.EPIRATIoN DATE THEREOF, NOME WILL BE OELIVERED IN :
<br /> ACC-I-RW.1'16E Willi THE POLICY PROVISIONS:
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<br /> ALIINGratiD RUPRERRNTRTWS
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<br /> Dulie-Sizemore/JSZN
<br /> ACORD 75(2009/09) 0'198B-2009 ACORD CORPORATION. All rights reserved,. -
<br /> INS025(mom The ACORD name and logo are registered marks of ACORD
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