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DocuSign Envelope ID: B2795506-A9C4-4F3C-BA37-9A4696263D77 <br /> Erie Insurance Exchange <br /> Erie Insurance <br /> 416, Exchange <br /> Member • Erie Insurance Group <br /> I00 Erie Ins.PI. • Erie,PA 16530 <br /> Ultrapack Plus Policy Declarations <br /> Renewal Certificate <br /> Mailing Name and Address for Insured: Other Interest: <br /> PICKETT-SPROUSE REAL ESTATE <br /> INC ,,,, <br /> PO BOX 52118 '1� ' <br /> DURHAM NC 27717-2118 .A.1, <br /> 122425196 <br /> JJ1013 <br /> Named Insured's Full Name: <br /> PICKETT-SPROUSE REAL ESTATE INC <br /> Agent: Policy Period: Policy Number: <br /> JJ1013 HERRING & BICKERS INS AGY INC 05/31/2016 to 05/31/2017 Q413190096 <br /> Agent Address and Phone <br /> HERRING&BICKERS INS AGY INC Policy begins at 12:01 A.M. standard time on the <br /> 2344 OPERATIONS DR STE 101 effective date and ends at 12:01 A.M. standard <br /> DURHAM NC 27705-1213 time on the expiration date. Standard time is <br /> 919-479-9900 determined at the stated address of the named <br /> insured. <br /> The insurance applies to those premises described below. This is subject to all applicable terms of the policy and <br /> attached forms and endorsements. <br /> Premium Summary <br /> Pay Plan Discount Applies <br /> Total Annual Policy Premium: $681.00 <br /> (This is not a bill. Your invoice will follow in a separate mailing.) <br /> Property Protection -As Per Attached Supplemental Declarations <br /> Deductible (Property Protection Only) $1,000 <br /> Policy-Level Coverages <br /> Liability Protection Limits of Insurance <br /> Commercial General Liability Limits of Insurance <br /> Each Occurrence Limit $1,000,000 <br /> Damage to Premises Rented to You $1,000,000 Any One Premises <br /> Medical Expense limit $5,000 Any One Person <br /> Personal&Advertising Injury Limit $1,000,000 Any One Person or Organization <br /> General Aggregate Limit $2,000,000 <br /> Products/Completed Operations Aggregate Limit $2,000,000 <br /> Processed On:03/17/2016 (See Reverse Side) <br />