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DocuSign Envelope ID:2E3BCFE8-9E55-4B63-900C-98F63F0612C6 <br /> ACl6 ® - DATE(MM/DD/YYYY) P <br /> CERTIFICATE OF LIABILITY INSURANCE 9/30/2016 <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 have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> NAME: Mike Cox <br /> Chandler and Trogdon <br /> PHONE/C,No,Ext): 3363751313 FAX No): <br /> 2223 North Church St AODR mikecox/�triad.rr.com • <br /> ADDRESS: li ' <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> Greensboro NC 27405 INSURER A: SOUTHERN INS CO OF VA 26867 <br /> INSURED INSURER B: SOUTHERN INS CO OF VA 26867 <br /> Carolina Awning INSURER C <br /> Fabricators LLC INSURER D: <br /> Po Box 512 INSURER E: <br /> Seagrove NC 27341-0512 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 /> INSK AUULbUCK EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY YY POLICY M/D YY <br /> (MM/DD/YYYY) (MM/DD/YYYY) LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000000 <br /> - <br /> UAMAGt IU KEN ItU <br /> CLAIMS-MADE I Xi OCCUR PREMISES(Ea occurrence) $ 100000 <br /> MED EXP(Any one person) $ 5000 <br /> A CPS8883180 10/25/2015 10/25/2016 PERSONAL a ADV INJURY $ 1000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2000000 <br /> — <br /> POLICY I I PRO <br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2000000 <br /> OTHER: PRDCO $ ' <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMI I $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> — <br /> OWNED —SCHEDULED BODILY INJURY accident) <br /> AUTOS ONLY AUTOS (Per accident $ <br /> HIRED —NON-OWNED PNOPEHIY DAMAGE <br /> AUTOS ONLY _AUTOS ONLY (Per accident) <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> — <br /> EXCESS LIAB CLAIMS-MADE <br /> AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER U I H- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100000 <br /> B OFFICER/MEMBER EXCLUDED? N/A WCS 8673867 10/26/2015 10/26/2016 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> ORANGE COUNTY THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO BOX 8181 AUTHORIZED REPRESENTATIVE <br /> HILLSBORO,NC 27278 <br /> t-ke, c <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br />