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DocuSign Envelope ID:9E1 F9021-C474-4807-8F93-1 C616BEBDEF1
<br /> BIRSI-2 OP ID: LE
<br /> AC-COREY DATE(MM/DD/YYYY)
<br /> CERTIFICATE OF LIABILITY INSURANCE 04/25/2017
<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 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 /> CONT
<br /> PRODUCER NAMEACT Lynne A Meyer,CIC,CPIW.AINS
<br /> Senn Dunn-GSO PHONE F
<br /> 3625 N.Elm St. (A/c,No.Ext):336-346-1302 (A/C,No): 336-346-1397
<br /> Greensboro,NC 27455 ADDRESS:Imeyer @marshmma.COm
<br /> David R.Clem
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURERA:National Fire Ins Co of Hffd
<br /> INSURED BIRS, Inc. INSURER B:Continental Casualty Company 20443
<br /> Mr. Raven Broeker INSURER C:Transportation Insurance Co. 20494
<br /> PO Box 36197
<br /> Greensboro,NC 27416-6197 INSURER D:Builders Premier Insurance Co. 13036
<br /> INSURER E:Columbia Casualty Company 31127
<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 /> ILTR TYPE OF INSURANCE N W
<br /> SD VD POLICY NUMBER POLICY EFF POLICY EXP
<br /> (MM/DD/YYYY) (MM/DD/YYYY)
<br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
<br /> CLAIMS-MADE X OCCUR C1071978219 05/01/2017 05/01/2018 pREM SES Ea occur ante) $ 100,000
<br /> MED EXP(Any one person) $ 5,000
<br /> X PERSONAL&ADV INJURY $ 1,000,000
<br /> GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
<br /> POLICY X PECOT- LOC PRODUCTS-COMP/OP AGG $ 2,000,000
<br /> OTHER: $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000
<br /> (Ea accident)
<br /> C X ANY AUTO C1071978222 05/01/2017 05/01/2018 BODILYINJURY(Perperson) $
<br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) $
<br /> AUTOS AUTOS
<br /> X HIRED AUTOS X UT
<br /> AOSWNED (Pea c dentDAMAGE $
<br /> Comp/Coll Ded $ 1,000/1,000
<br /> X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000
<br /> B EXCESS LIAB CLAIMS-MADE C1071978253 05/01/2017 05/01/2018 AGGREGATE $ 5,000,000
<br /> DED X RETENTION$ 0 $
<br /> WORKERS COMPENSATION X PER 0TH-
<br /> AND EMPLOYERS'LIABILITY STATUTE ER
<br /> Y
<br /> D ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A PWC10002907 05/01/2017 05/01/2018 E.L.EACH ACCIDENT $ 500,000
<br /> OFFICER/MEMBER EXCLUDED?
<br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below , E.L.DISEASE-POLICY LIMIT $ 500,000
<br /> B Rental Equipment C1071978219 05/01/2017 05/01/2018 Limit 160,000
<br /> E E&0/Pollution 0E05091855996 05/01/2017 05/01/2018 Limit 1,000,000
<br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANINS
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> PO Box 8181
<br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE
<br /> 0 ot,p, C ,
<br /> 1
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<br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
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