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DocuSign Envelo pe ID: DDOCFB B6 22- 8EDD- 4B57- ACF6- 9C98BO78AA95 <br />t © uto— ow1wrs Page 3 <br />AGENCY COPY <br />(MUTUAL) INSURANCE COMPANY <br />6101 ANACAPRI BLVD., LANSING, MI 48917 -3999 <br />AGENCY HIGH & RUBISH INSURANCE AGENCY <br />15- 0936 -00 MKT TERR 050 (919) 913 -1144 <br />INSURED ORANGE COUNTY LITERACY COUNCIL INC <br />ADDRESS 200 N GREENSBORO ST STE C2 <br />CARRBORO NC 27510 -1849 <br />Policy change: Effective Date of Change MO DY YR <br />Cross out old information and write in the changes. <br />54643 (01 -90) <br />Issued 10 -05 -2017 <br />BUSINESSOWNERS POLICY DECLARATIONS <br />Renewal Effective 11 -20 -2017 <br />POLICY NUMBER 91- 159 - 372 -01 <br />Company Use 35 -57 -NC -9311 <br />Company POLICY TERM <br />Bill 12:01 a.m. 12:01 a.m. <br />to <br />11 -20 -2017 11 -20 -2018 <br />RATING INFORMATION <br />Occupancy: Office Not Otherwise Classified Tenant Occupied <br />Class Code: 65121 Const: Non - Combustible, Sprinklered <br />Program: Office Protection Class: 03 <br />Liability Rate Number: 00 Territory: 010 Orange County <br />Burglary Rate Group: 00 <br />Construction Year: 1965 <br />TERM <br />TOTAL ANNUAL PREMIUM 5230.09 <br />MINIMUM PREMIUM EQUIPMENT BREAKDOWN ADJUSTMENT $31.22 <br />MINIMUM PREMIUM ADJUSTMENT $178.81 <br />TOTAL POLICY PREMIUM $440.12 <br />PAID IN FULL DISCOUNT -22.56 <br />TOTAL POLICY PREMIUM IF PAID IN FULL $417.56 <br />The Paid In Full Discount does not apply to fixed fees or statutory charges. <br />Paid In Full Discount is available. <br />Discount Applies for Affiliation with: CHAPEL HILL - CARRBORO CHAMBER OF COMMER <br />A 2% Cumulative Multi-Policy Discount applies. Supporting policies are marked with <br />an (X): Comm Umb( ) Comm Auto( ) WC(X) Life( ) Personal( ) Farm( ). <br />Billing Type: Company Bill - Full Pay Account 009652074 <br />Merit Rating Discount of 5% Applies <br />440120190 <br />1000 <br />