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DocuSign Envelope ID:AAB48FBD-7E41-49ED-AF28-FCE317917B07 <br /> PICKROO-01 CSHUMPERT <br /> CERT'IFICA'TE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) <br /> 6/3/2016 <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 1NSURER(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 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 lieu of such endorsement(s), <br /> PRODUCER NAMEACT Cindy Shumport <br /> Davis-Garvin Agency,Inc.-SC PHONE FAX <br /> One Fornandina Court faro.No,Ext):{803}732-6331 (Arc,No): (803)407-5400 <br /> Columbia,SC 29212 n odlEss:cshampert @davisgarvin.com <br /> INSURER(S)AFFORDING COVERAGE ' NAIC I/ <br /> INSURERA:Carolinas Roofing&Sheet Metal Contractors SIF 20006 <br /> INSURED INSURER B: <br /> Pickard Roofing Company,Inc. INSURER C: <br /> 825 ETrinity Ave INSURER A: <br /> Durham,NC 27704 INSURERS: <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 /> jN7E TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP <br /> INSD NlVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ <br /> DAMAGE CLAIMS-MADE OCCUR PREMSESO(Ea olccuFence) $ <br /> MED EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ <br /> GENT.AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ $ <br /> POLICY JECT LOC PRODUCTS-COMP/OP AGG $ <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS NOON OWNED PROPERTY DAMAGE <br /> HIRED AUTOS _ AUTOS {Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE $ • <br /> BED RETENTION$ _ J $ <br /> WORKERS COMPENSATION X I TUTE (OTH <br /> AND EMPLOYERS'LIABILITY <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN X CRS0000057 01/01/2016 01/01/2017 E.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? ( N I N/A <br /> (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> If yes,describe under I <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE POLICY LIMIT $ 1,000,000 PP <br /> � z <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> Joh: Old Court House-Hillsborough <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County NC THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough,NC 27278 <br /> AUThOORIZED REPRESENTATIVE <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />