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DocuSign Envelope ID: 56102356-060A-4AC6-A0C9-F3D72B13FA70 <br /> ------4 , <br /> 1 DATE(MM/IDDNYYY) <br /> A C 0 R a CERTIFICATE OF LIABILITY INSURANCE 12/1/2016 <br /> 1...-- <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(SI, AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain polIcles may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder In lieu of such endorsement(s). <br /> PRODUCER 'CONTACT <br /> I NAME <br /> ROGER HILL INSURANCE AGENCY PHONE <br /> (434) _INC o <br /> 581-3287 FAx (434)581-3289 <br /> MiSt N ) <br /> PO Box 117 <br /> Atmliessrogerhill@earthlink.net <br /> Arvonia, VA 23004 <br /> mouRER4111 AFFORDING COVE RAOE NAICs <br /> ... _ <br /> INSURER A MILLI:RS CAPITAL INSURANCE CO. <br /> INSURED PEARSON'S APPRAISAL SERVICE, INC. INSURER B <br /> P 0 BOX 36404 INSURER C <br /> RICHMOND, VA 23235 ' 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 /> INSR AD01-7-3:0101 . -POLICia-EXP. <br /> L TR TYPE OF INSURANCE a'so VND POLICY NUMBER ..(MM/DO/YYYYL(MMADD/YYYY) LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1 000 000 <br /> 1 1___ <br /> "D'AMAGE-TO-REN i E LI <br /> CLAIMS-MADE X OCCUR , <br /> PREMISES,(Ea occlaence) .$ 0,000 <br /> . - . <br /> MED EXP(Any one peesoni S 5,000 <br /> --- - _ . <br /> A BOP001636816 11/22/1511/22/16 PERSO ADV INJUR <br /> NAL 5. Y <br /> 1 $ 1,000,000 <br /> , _„_ <br /> GEN.AGGREGATE LIMIT APPLIES PER ; <br /> I GENERAL AGGREGATE $ 2,000,000 <br /> .- <br /> - PRO- ■ ' <br /> -POLICY/ JECT LOC , PRODUCTS-COMP/OP AGG.$ 2,000,000 <br /> .. _ ,.._. <br /> OTHER I , $ <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ <br /> • <br /> . , <br /> , <br /> _(Ea ecoderel . . <br /> ANY AUTO <br /> BODILY INJURY(Per person) S <br /> ALL OWNED SCHEDULED 'BODILY INJURY(Per acodenp $ <br /> AUTOS ,__ AUTOS <br /> NON•OWNED I PROPERTY—D-AMAGE - — ---- <br /> f <br /> _ HIRED AUTOS AUTOS ( xl <br /> Per accent), _ _ <br /> 1 <br /> . , <br /> . <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE .5 <br /> _ <br /> _ „ -,EXCESS LIA8 CLAIMS-MADE , AGGREGATE S <br /> OED , RETENTIONS S <br /> PER <br /> WORKERS COMPENSATION 0TH- <br /> AND ER <br /> AND EMPLOYERS'LIABILITY Y/N <br /> ANT PROPRIETOR/PART NER.E//ECLITIVE — E L EACH ACCIDENT S <br /> OFFICER/MEMBER EXCWOBD, NIB __ ..., _.____— _ <br /> - <br /> 110.0.1oty rn N141 ' _E L DISEASE-EA EMPLOYEE S <br /> -- <br /> 1.4Tdidt.1117110:1 OF OPERATIONS below , , E L DISEASE•POLICY LIMIT S <br /> DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101 Ad:abased Remarks Schedule may be&Uchida more space a reclarea) <br /> APPRAISAL OF REAL ESTATE <br /> APPRAISAL OF NEW RESIDENTIAL CONSTRUCTION <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY, NC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> T. DWANE BRINSON TAX ADMINISTRATOR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 228 S CHURTON STREET ACCORDANCE WITH THE POLICY PROVISIONS <br /> HILLSBOROUGH, NC 27278 <br /> FAX 919-644-3091 AUTHORIZED REPRESENTATIVE <br /> EMAIL:dbrinson@orangecountync.gov Aj 'IAA <br /> e 1988-2013 ACORD CORPORATION All rights reserved <br /> ACORD25(2013/04) The ACORD name and logo are registered marks of ACORD <br />