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DocuSign Envelope ID: 9390DEFB -51EE- 4441- 8D3B- OC3A8B573C85 <br />AC" R" CERTIFICATE OF LIABILITY INSURANCE °02;02,20 <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 the <br />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 Greg Lopeman, CPCU CAA0MEACT Greg Lopeman <br />PHONE FAX <br />State Farm Insurance v. Ext1. 919 933 -7770 _ (AIC, No): 919 -933 -7713 <br />"AR <br />104 -B NC Hwy 54 W ADDREss: Gre .Lo eman.NYSL Statefarrn.com <br />1 �4' Carrboro, NC 27510 _ INSURER {$I AFFORDING COVERAGE NAIC # <br />L==9 `_•9 _ INSURER A. State Farm Frre and Casualty Company 25143 <br />INSURED RILEY SURVEYING PA INSURER n _ State Farm Mutual Automobile Insurance Company 25178 <br />STE 100B INSURE IZC: -- _ <br />3326 DURHAM CHAPEL HILL BLVD INSURER D: _ - <br />DURHAM NC 27707 -2695 INSURERS: --- <br />COVERAGES rFRTIFIrATF All IMRGr7• oc►ncinm h111RiCrD. <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />1NSR I ADDLiSUBR pOLiCY EFF - �- POLICY E %P <br />LTR TYPE OF INSURANCE POLICY NUMBER MMtDDrfYYY MMIDDIYYYY LIMITS <br />I1 <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL LIABILITY <br />- CIA11418 -MADE Fx—] OCCUR <br />_ <br />GEN'L AGGREGATE LIMIT APPLIES PER: <br />X POLICY -1 PRO LOC <br />} <br />LJ <br />93{ G- 240$ -$ <br />93 CG 2465 -8 <br />02!20!20113 <br />02f2412f117 <br />0212OF2019 <br />[I2f20F2018 <br />EACH OCCURRENCE <br />DAM,AG 'it(Ea RAN D <br />PREMISES ocevvrnce ) <br />$ 7,000,009 <br />300.000 <br />ME_D_EXP (Any one Person) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />GENERAL AGGREGATE_ <br />$ 1,000,000 <br />2,000,000 <br />PRADUCTS - COMPIOP AGG <br />_$_ <br />$ 2,000,000 <br />$ - -- <br />B <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED SCHEDULED <br />AUTOS X AUTOS <br />HIRED AUTOS X NON -OWNED <br />_ AUTOS <br />❑ <br />071 9714- D30 -33 <br />10/30/2017 <br />10130/2418 <br />MBINED <br />Ea a.id., SINGLE LIMIT <br />-.. <br />S 540.004 <br />BODILY INJURY (Pet person) <br />-- <br />BODILY INJURY (Per accwanl) <br />PROPERTY DAMAGE <br />IPeraccident <br />- - -" <br />$ 500,000 <br />_ <br />S 100,000 <br />Is <br />A <br />UMBRELLA LIAB X OCCUR <br />EXCESS LIAB CLAIMS -MADE <br />DED X RETENTIONS 10,000 <br />93- GM- 1111 -1 <br />U8/1a12a17 <br />OtYfaOl2o18 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />_._ <br />$ 1,000,000 <br />AGGREGATE <br />- - -- <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERJFXEC.UTIVE <br />OFFICEIMEMSER EXCLUDED? <br />1 (Mandatory in NH) <br />If yes, descrfbe under <br />N d A <br />�� <br />93- CV- L457 -5 <br />93-CC- 0931 -6 <br />02!20!201$ <br />02/2012017 <br />0212012039 <br />0212012018 <br />WC STATU -. 0TH- <br />- <br />5 1,000;404 <br />E.L. EACH ACCIDENT' <br />-- - -- <br />E.L. DISEASE - EA EMPLOYEd <br />E.L. DISEASE •POLICY LIMIT <br />$ 1,040,000 <br />S 1,000,000 <br />El <br />El <br />DESCRIPTION OF OPERATIONS I LOCATIONS d VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />Orange County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />PO BOX 8.181 ACCOR NCE WITH :7 POLICY PROVISIONS. <br />Hillsborough, NC 27278 - --- -_" - - - <br />(M988 -2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010145) The ACORD name and Toga are registered marks of ACORD 1001486 132849.6 11 -15 -2010 <br />