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c.�..-.o..,.u.-..-,........,c_..r n.�..__: Page 2 of 2 Date:1011712018 11:24 AM Page:2 of 2 <br /> DocuSign Envelope ID: 14FC5B48-BC47-4D69-A35B-36A5BD8B6779 <br /> OP ID:LH <br /> ,acvrza CERTIFICATE OF LIABILITY INSURANCE D1 1011012D18 <br /> THIS <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 pollcy(ies) must he endorsed. It 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 Phone. 918-682-4814 CONTACT Leo Hammond <br /> The Sorgl Insurance Agency NAME: FA]C <br /> 16 Consultant Place Suite 102 Fax: 919-682-4906 .919.682-4814 Arc Na; 919 882 49(}6 <br /> Durham,NC 27707 E-MAIL lee svr iinsurance.cmm - - <br /> James E.Sorg€,CIC PooucelR <br /> CUSTOMER ID P.BBLEELE <br /> INSURER(S)AFFORDING COVE RAGLE. _NAICk — <br /> INSURED B.B.Lee Electric Co. INSURER A;Erie I nsuranc e E Xc h Ong 0 26271 <br /> Bill Bernice Lee, Jr. INSURER B:Flagship City Insurance Co <br /> 8014 Bill Poole Rd. --.- — - -- - <br /> Rougemont,NC 27572 tNSURSRC: <br /> INSURER D; _ <br /> INSURER E: <br /> INSURERF: <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 A13OVE 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 TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP - - <br /> LTR POLICY NUMBER Im MIDDJYYYY MMIDDIYYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,004,40 <br /> AMAGE TO RE NTF <br /> A X COMMERCIAL GENERAL LIABILITY Q28-1920407 0411912018 44119/2019 PREMISES Eaarmurrencs $ 1,000,00 <br /> CLAIMS-MAO F, t-J OCCUR In ED E XP(Any one poison) $ s,40 <br /> PERSONAL 3 AUV INJURY $ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,40 <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-GOMPIOP AGG $ 2,000,00 <br /> X POLICY PRO LOC A <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Fnno:idnnl) a 1,000,00 <br /> ANY AUTO BODILY INJURY(Par parson) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Per accldant) $ <br /> A X SCHEQULEDAUTOS 0082330799 46123/2418 0612312019 PROPERTY DAMAGE <br /> A X HIRED AUTOS Q062330799 05123/2018 0612312019 (Pets cidern) $ <br /> A X NON-OWNEDAUTDS 0062330799 4612312018 46123/2019 <br /> UMBRELLA LIAR r OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAR CLAIMS-MACE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION NlC STATU• I X OTH- <br /> YIN ER <br /> AND EMPLOYER$LIABILITY 072®11i.1.,11D9S <br /> B ANY PROPRIETMPARTNFI?J"ECUTIVE 0712$12.0'18 0712812019 E,L.EACHACGIDENT 3 1,000,04 <br /> OFFICERIMEMBEREXCLUDED? NIA <br /> (Mandatary in NH) E.L DISEASE-EA E W LOYEE $ 1,000,00 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 3 1,000,00 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES(Allach ACORD 101,Additfonai Remarks Schedule,If move space is requlredl <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough, NC 27278 AUTHomzEnREPRESE[NT�ATIVE y� <br /> Q 1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of AGORID <br /> I <br /> 1 <br />