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DocuSign Envelope ID:A034BEFC-1769-4A2A-B443-DC7C17813746 <br /> NORTH CAROLINA FARM BUREAU MUTUAL INSURANCE COMPANY, INC. <br /> CERTIFICATE ! ILI 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 PAUL L WILKERSON JR CERTIFICATE ORANGE COUNTY GOVERNMENT <br /> NAME AND 4600 BROCK DR HOLDER ALLISON RIENERT <br /> ADDRESS HURDLE MILLS NC 27541-8280 Stoneham, MA 02180 <br /> PO BOX 8181 <br /> 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 ADSDDL SUBR POLICY NUMBER (MM <br /> POLICY EFF <br /> n (POLICY EXP <br /> YY) LIMITS <br /> ❑ COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ <br /> -OCCURRENCE PRODUCTS-COMP/OPS <br /> AGGREGATE $ <br /> GEN'L AGGREGATE APPLIES PER POLICY PERSONAL&ADV INJURY $ <br /> EACH OCCURRENCE $ <br /> DAMAGE TO RENTED $ <br /> PREMISES(Ea Occurrence) <br /> MED EXP(Any one person) $ <br /> ❑ EACH OCCURRENCE $ <br /> BUSINESSOWNERS AGGREGATE <br /> COMBINED SINGLE LIMIT <br /> AUTOMOBILE LIABILITY _ (Each accident) $1,000,000 <br /> BAP2005781 12/30/2016 6/30/2017 BODILY INJURY(Per person) $ <br /> • SCHEDULED AUTOS <br /> ❑ HIRED AUTOS BODILY INJURY(Per accident) $ <br /> ❑ NON OWNED AUTOS PROPERTY DAMAGE <br /> (Per accident) <br /> LI GARAGE LIABILITY <br /> ❑ (Other) <br /> El EXCESS LIABILITY— EACH OCCURRENCE $ <br /> OCCURRENCE AGGREGATE <br /> ❑ WORKERS COMPENSATION N/A WC STATUTORY NMITS <br /> AND EMPLOYERS'LIABILITY E.L.EACH ACCIDENT <br /> POLICY APPLIES TO THE WORKERS E.L.DISEASE-EA EMPLOYEE $ <br /> COMPENSATION LAW IN THE STATE OF NC E.L.DISEASE-POLICY LIMIT $ <br /> OTHER: Additional insured Orange County Government, PO BOX 8181, Hillsborough NC 27278 <br /> DESCRIPTION OF OPERATIONS/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 4/24/2017 <br /> COI 0910 <br />