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DocuSign Envelope ID: 35C3F1DF- FF21- 4D08- 9BF4- 47BAE013F645 <br />BIRSI -2 OP ID: LE <br />ACOROy <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM /DD /YYYY) <br />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 />PRODUCER <br />Senn Dunn - GSO <br />3625 N. Elm St. <br />Greensboro, NC 27455 <br />NAME: Lynne A Meyer, CIC, CPIW. AINS <br />PHONE FAX <br />A/c No, : 336- 346 -1302 ac, No :336- 346 -1397 <br />E- MAIL <br />ADDRESS: lmeyer@marshmma.com <br />David R. Clem <br />C1071978219 <br />0510112017 <br />0510112018 <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A: National Fire Ins Co of Htfd <br />—AMAGE —TO <br />PREM SES Ea occur ence <br />$ 100,00 <br />INSURED BIRS, Inc. <br />INSURER 8: Continental Casualty Company <br />20443 <br />Mr. Raven Broeker <br />PO Box 36197 <br />Greensboro, NC 27416 -6197 <br />INSURER C: Transportation Insurance Co. <br />20494 <br />INSURER D: Builders Premier Insurance Co. <br />13036 <br />INSURER E: Columbia Casualty Company <br />31127 <br />PRODUCTS - COMP /OP AGG <br />INSURER F: <br />$ <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />ADDL <br />IN SD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />MM /DD/YYYY <br />POLICY EXP <br />MM /DD/YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE ® OCCUR <br />C1071978219 <br />0510112017 <br />0510112018 <br />EACH OCCURRENCE <br />$ 1,000,00 <br />—AMAGE —TO <br />PREM SES Ea occur ence <br />$ 100,00 <br />MED EXP (Any one person) <br />$ 5,00 <br />X <br />PERSONAL & ADV INJURY <br />$ 1,000,00 <br />GENT AGGREGATE LIMIT APPLIES PER: <br />POLICY ® PRO- <br />JECT EI LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$ 2,000,00 <br />PRODUCTS - COMP /OP AGG <br />$ 2,000,00 <br />$ <br />C <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS AUTOS <br />NON -OWNED <br />X HIRED AUTOS X AUTOS <br />01071978222 <br />0510112017 <br />05/0112018 <br />COMBINED SINGLE LIMIT <br />Ea accident <br />$ 1 000 00 <br />, , <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROP cc ER DAMAGE Per <br />a id <br />$ <br />Comp /Coll Ded <br />$ 1,000 /1,00 <br />B <br />X <br />UMBRELLA LIAB <br />EXCESS LIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />C1071978253 <br />0510112017 <br />05/01/2018 <br />EACH OCCURRENCE <br />$ 5,000,00 <br />AGGREGATE <br />$ 5,000,00 <br />DED I X I RETENTION $ 0 <br />$ <br />D <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR /PARTNER /EXECUTIVE YI <br />OFFICER /MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />N/A <br />PWC10002907 <br />05/01/2017 <br />05101/2018 <br />X P ER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ 500,00 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 500,00 <br />E.L. DISEASE - POLICY LIMIT <br />1 $ 500,00 <br />B <br />E <br />Rental Equipment <br />E & O /Pollution <br />C1071978219 <br />CE05091855996 <br />05/0112017 <br />05101/2017 <br />05/01/2018 <br />05/01/2018 <br />Limit 160,00 <br />Limit 1,000,00 <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 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />PO Box 8181 <br />AUTHORIZED REPRESENTATIVE <br />Hillsborough, NC 27278 <br />ACORD 25 (2014/01) <br />©1988 -2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />