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DocuSign Envelope ID: 7796CD94- 342E- 40DO- B7C3- A2B604F926B4 <br />" -Fri " CERTIFICATE OF LIABILITY INSURANCE <br />DATE ;ManmOrYYrY> <br />THIS CERTIFICATE 1S ISSUED As A MATTER CIF INFf7RMATIOM DNIY ANp CGIVFER9 {VD RIGHTS UPON 7H14 CERTIFICATE HflLb> I{, T S!{t912fD48 <br />CERTIFICATE DOES NDTAFFIRI47ATIVELY OR NI =GATIVELY AMEND, EXTEND OR ALTER THS COVERAGE AFFORDED BY THE POLICIES <br />REPREBELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTHACT BETWEEN THE ISSUING INSURER ($),AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIPICATE HOLDER, <br />SENTATIVE <br />It tale car�iflcsta Mulder le an RDpITIO AL SURED,1ha RoIIGyjlaaj must haVO ADp1TfONAL INSURI+p Proytsl4na or It 01 #Oraed. <br />If SUBROGATION 19 WAIVED, aubjeot to the terms and Conditions of the p0llcy, certain policies may raqulro an ondoraBmant, A statemant on <br />this cerlltloate does not confer rights to the certificate holdor In Hall or auch ondorsomollt(a <br />PRODUCER <br />Peinik Insurance hADanr : Robes T16Gs <br />Pf {GNe f9r9)as9•ao9D <br />10D RYdgavlew Drive No ; 868)714. 5778 <br />Suite 100 6DbkEss: Roam TIbtJB @Patnik.com <br />Cary NC 27511 INSURERI9 AFFOROINGCOV&RAoE HAICn <br />NSURCD INSURERA: Frankenmulh Mutual Ins Co 13980 <br />JUDY D BROOKS CONTRACTOR INC INSURERS: <br />1196 BEAL RD INSURER c <br />INSURER D i <br />GOLOSTON INSURERc <br />NC 27262•9595 INSUReTIF: <br />COVERAGES CERTIFICATE NUIUBER: CL1112201626? <br />THIS IS TO CNOT WI THAT THE POLICIES OF ENSURAIYCE LISTED aELOGV HAVE BEEN ISSUED TO THE INSURED NAMEQ ASOVE15DR1 THE POLICY PERIOD <br />INDICATED NOTVNTHSTANOINCiAHY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT Olt OTHER DOCUMENT WITH RESPECT TO W11ICH THIS <br />CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURA NCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE PERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS E•HOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />LSR TYPEOFINSURANCE 06R.. <br />X COMMERCIALGENERALUAaILITY I - pOLPCYNUMBER Mmi IpO�Yy MMLWYYVY <br />LIMITS <br />C4AIM5•IAADE ® OCCUR EACH OOCVRRENCE y t,e00,000 <br />PRE^A�T SE3 E ,curro.w g BOD,OOC <br />A Y CPP80001 b4 ME[) EXP eAa pe wn g 6,000 <br />02ItB/2018 02/In12D19 PEREONALRADVINJURY s 1,000,000 <br />GEN LAGOR €GATE LIMIT APPLIES DER: <br />POLICY N JEGT E] LOG OENERALAGGREGATE $ 2,000,040 <br />OTHER: PRODUCTS •COM_ PKOPAf3G I 2.00n,000 <br />AU1bMOaslI.E LIABILITY ; <br />}(� <br />AUTO E aINa BI LEUMS 3 1,000,000 <br />A 'g OWNED SCHEDULED ROOILY INJURY 1prr potion) S <br />AUTOS ONLY AUTOS BA 3000154 02!1012010 0214 9r2019 BODILY 1"RY YPnr accldanls ; <br />HIRED NON-OWNED - - <br />AUTOSONLY !"� AUTOS ONLY W PER4I AMA E ; <br />UMe RELLALIAe X OCCUR T- <br />A EXCESS LIAR CLAIMS -MA D$ CPP6000154 02/1012018 02/M2019 EAC1IOCCURR£NCE g 6.000,000 <br />oEO X RETE�IflON ; 10.000 <br />AGGREGATE ; 6,000,000 <br />WORMERS COMPENSAIION - b <br />AND EMPLOYERS" LIABILITY g <br />ANY PROPRIETONPARTNERIEXeCUTIVE YIN X STATUTE ER <br />A OFFICCRrr.tEMBER EXCLUDED? NIA M ODOO164 02718/2010 02118/2079 EL EACH FCCiCCNT g 1,000,000 <br />tadandatury In NHl <br />II yiL descaba under E L CISWE. EA EMPLOYS ; 1,000,000 <br />DEBCRIPTrDN OF pFD•RgTEDNS 6ofaw <br />E.L. DISEASE • POLICY Li- 11 s 1,000,000 <br />A Leased /!tented Equipment LIMO 5851000 <br />CPF16000164 D211 U12018 02/1012019 DeduCllble <br />$500 <br />F$SfdOD.FSLi ERATIONa a LOCATIONS 7 VEZnCLES (AG0R01G1, Ad!11!ldrisr RimirMi 3cNmduli, may Ian n:Ninhod If mnra SPA 00 Is nqulred) <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION {LATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS, <br />AU THRR3Xe0 REPREaM I AT1yE <br />ACORD 25 (2019103) 01988.2016ACORD CORPORATION, All rights reserved. <br />TheACORD name and logo are registered marks Of ACORD <br />