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DocuSign Envelope ID:AD429797-DE7F-427B-B28B-5BF443926C54 <br /> NORTH CAROLINA FARM BUREAU MUTUAL INSURANCE COMPANY, INC. <br /> CERTIFICATE OF LIABILITY INSURANCE <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 policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject <br /> to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to <br /> the certificate holder in lieu of such endorsement(s). <br /> INSURED Nelson Alarms CERTIFICATE Orange County <br /> NAME AND P.O. Box 10 HOLDER P.O. Box 8181 <br /> ADDRESS Randleman, NC 27317 Hillsborough, NC 27278 <br /> COVERAGES <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 /> X TYPE OF INSURANCE ADDL.SUBOR POLICY NUMBER (POO/LIICYEF (POOLII Y YY) LIMITS <br /> INSD IA COMMERCIAL GENERAL LIABILITY SMP 0113241 5/26/2016 5/26/2017 GENERAL AGGREGATE $1 000000 <br /> -OCCURRENCE PRODUCTS-COMP/OPS <br /> AGGREGATE $1,000 000 <br /> GEN'L AGGREGATE APPLIES PER POLICY PERSONAL 8 ADV INJURY $1,000,000 <br /> EACH OCCURRENCE $1,000,000 <br /> DAMAGE TO RENTED $100,000 <br /> 000 <br /> w <br /> PREMISES lEa Ocrrence) <br /> MED EXP(Any one person) $5,000 <br /> ❑ EACH OCCURRENCE $ <br /> BUSINESSOWNERS <br /> AGGREGATE $ <br /> AUTOMOBILE COMBINED SINGLE LIMIT <br /> UTOMOBILE LIABILITY $ <br /> (Each accident) <br /> ❑ SCHEDULED AUTOS BODILY INJURY(Per person) $ <br /> ❑ HIRED AUTOS BODILY INJURY(Per accident) $ <br /> ❑ NON-OWNED AUTOS PROPERTY DAMAGE <br /> Per accident) <br /> El GARAGE LIABILITY <br /> CI <br /> (Other) <br /> El EXCESS LIABILITY— EACH OCCURRENCE $ <br /> OCCURRENCE AGGREGATE $ <br /> WC STATUTORY LIMITS <br /> ® WORKERS COMPENSATION N/A WC 0213731 6/21/2016 6/21/2017 $100,000 <br /> AND EMPLOYERS'LIABILITY F.L.EACH ACCIDENT <br /> POLICY APPLIES TO THE WORKERS E.L.DISEASE-EA EMPLOYEE $1 00,000 <br /> COMPENSATION LAW IN THE STATE OF NC E.L.DISEASE-POLICY LIMIT $500,000 <br /> OTHER: <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES: <br /> CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED AUTHORIZED REPRESENTATIVE <br /> BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br /> DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. DATE 8/9/2016 1 <br /> COI 0910 <br />