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DocuSign Envelope ID: F7CD390C -D39C- 431E- 8BF1- 64E98FD291FE <br />FO 1851141 441 COINSURANCE CONTRACT <br />NORTH CAROLINA FARM BUREAU MUTUAL INSURANCE COMPANY PART B DECLARATION PAGE <br />P.Q. BOX 27427 RALEIGH, NORTH CAROLINA 27611.7427 FARMOWNERS POLICY <br />POLICY RENEWAL DECLARATION — COVERAGE WILL <br />EXPIRE ON 89/85/18 IF PREMIUM IS NOT PAID. <br />I FO 1051141 109/05/18 09/05/191 09087301 FORM# FBFO —D 10101 06855641 <br />ALLAN GREEN <br />CHRISTINE GREEN <br />5604 DAIRYLAND RD <br />HILLSBOROUGH, NC 27278 -7481 <br />MICHAEL R DECKER <br />TELE: (919) 960 -6801 <br />102 S ESTES DR <br />CHAPEL HILL, NC 27514 <br />L. M. SQUIRES 07/21/18 <br />AUTHORIZED REPRESENTATIVE DATE <br />DESCRIPTION OF ADDITIONAL COVERAGES <br />COVERAGE F <br />PLEASE REFER TO THE FOLLOWING FOR OPTIONAL COVERAGES DESCRIPTIONS, AS APPLICABLE <br />TO YOUR POLICY <br />*A — WEIGHT OF ICE, SNOW OR SLEET COVERAGE APPLIES <br />*B — ADDITIONAL EXTENDED COVERAGE APPLIES <br />*C — ALL RISKS COVERAGE APPLIES <br />REPL OPTIONAL <br />ITEM DESCRIPTION COST CONST COVERAGES INS AMT DED PREMIUM <br />1 2008 LARGE BARN LIVESTOCK & Y F *C $100000 $250 $970 <br />GARAGE <br />2 GREENHOUSE INCLUDING Y F *C $3000 $250 $73 <br />PLASTIC <br />DESCRIPTION OF ADDITIONAL PREMIUMS <br />ANIMAL COLLISION — FBL08 $14 <br />NUMBER OF HEAD = 1 TO 100. <br />REFRIGERATED PROPERTY — $180 DEDUCTIBLE -- FBP26 $10 <br />PREMISES ALARM OR FIRE PROTECTION SYSTEM — ML216 <br />PRIMARY RESIDENCE, LOCAL FIRE /SMOKE ALARM. $9CR <br />