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DocuSign Envelope ID:AD43A22F-6754-4919-9754-D100376EF19E <br /> PROGRESS/1E' <br /> JACKSON INS AGENCY COMMERCIAL <br /> 231 E CHURCH ST <br /> MARTINSVILLE,VA 24112 <br /> 1-276-728-4212 Policy number: 03353876-2 <br /> Underwritten by: <br /> PROGRESSIVE SOUTHEASTERN INS CO <br /> March 23,2017 <br /> Page 1 of 2 <br /> Certificate of Insurance <br /> Certificate Holder Insured Agent <br /> ORANGE COUNTY NC NEW RIVER TIRE RECYCLING JACKSON INS AGENCY <br /> 200 S CAMERON ST LIC 231 E CHURCH ST <br /> PO BOX 8181 312 E 52 BYPASS MARTINSVILLE,VA 24112 <br /> HILLSBOROUGH,NC 27278 PILOT MT,NC 27041 <br /> This document certifies that insurance policies identified below have been issued by the designated insurer to the insured <br /> named above for the period(s)indicated. This Certificate is issued for information purposes only. It confers no rights upon <br /> the certificate holder and does not change,alter,modify,or extend the coverages afforded by the policies listed below. <br /> The coverages afforded by the policies listed below are subject to all the terms,exclusions,limitations, endorsements,and <br /> conditions of these policies. <br /> Policy Effective Date: Nov 3,2016 Policy Expiration Date: Nov 3,2017 <br /> Insurance coverage(s) Limits <br /> BODILY INJURY/PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT <br /> COMBINED UM/UIM BI $1,000,000 COMBINED SINGLE LIMIT <br /> Description of Location/Vehicles/Special Items <br /> Scheduled autos only <br /> 2006 FRHT COL 1 FUJA6CK26LW32144 Stated Amount $40,000 <br /> UNINSURED MOTORIST PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT W/$100 DED <br /> MEDICAL PAYMENTS $2,000 <br /> COMPREHENSIVE $1,000 DED <br /> COLLISION $1,000 DED <br /> 2004 EAST TRAILER 1E1 U222894RA34268 Stated Amount $20,000 <br /> COMPREHENSIVE $1,000 DED <br /> COLLISION $1,000 DED <br /> 2007 FRHT COL 1 FUJA6CK971X34171 Stated Amount $24,000 <br /> UNINSURED MOTORIST PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT W/$100 DED <br /> MEDICAL PAYMENTS $2,000 <br /> COMPREHENSIVE $1,000 DED <br /> COLLISION $1,000 DED <br /> 2016 CHEVROLET SILVERADO C2500 1 GC1 KVE88GF160631 <br /> UNINSURED MOTORIST PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT W/$100 DED <br /> COMPREHENSIVE $1,000 DED <br /> COLLISION $1,000 DED <br /> 2006 INTL 9412HSCNAPR26C228566 Stated Amount $8,500 <br /> UNINSURED MOTORIST PROPERTY DAMAGE $1,000,000 COMBINED SINGLE LIMIT W/$100 DED <br /> MEDICAL PAYMENTS $2,000 <br /> COMPREHENSIVE $1,000 DED <br /> COLLISION $1,000 DED <br /> Conanue <br />