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DocuSign Envelope ID: B4FCE778-8528-44CE-AA6B-2D12919CBB9B <br /> CHAPHIL-01 MWITHROI+'if <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDAIYYYY) <br /> 09/26/2018 <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(les)must have ADDITIONAL INSURED,Provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER NEW CT <br /> Harold W.Wells&Son,Inc. PHONE FAX <br /> 1 N 3rd Street AIC,No,Ext 91 D 762-8551 1 Arc No: 910 254-9404 <br /> Wilmington,NC 28401 <br /> E-MAIL RES,insurance @welisins.com <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A;TransGuard Insurance Company of America Inc <br /> INSURED INSURER B:Brid efield Casualty Insurance 10335 <br /> CHAPEL HILL MOMNG CO INC INSURERC: <br /> 7401 REX RD STE 104 INSURERD: <br /> CHAPEL HILL, NC 27518 <br /> INSURER E: <br /> INSURER F: <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 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY Err POLICY E.XP LIMITS -- <br /> 3D IDD IMMIDDIYYYYI <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE Fx-]OCCUR TCP0001375.00 0410112018 0410112019 DAMAGE TO RENTED 5 100,000 <br /> eccurrence <br /> MEDEXp(Anyone person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,O00,DDD <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL.AGGREGATE $ 2,000,000 <br /> X POLICY j�� r <br /> 17 LOC PRODUCTS-COMPIOP AGG $ 2 000 000 <br /> OTHER: Empl Benefits $ 1,000,000 <br /> A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 <br /> ANY AUTO TCP0001375.00 0410112018 0410112019 BODILY INJUIiY.(per person) 5 <br /> OWNED SCHEDULED <br /> AIllT4S ONLY <br /> AUTOS p BODILY INJURY Per acddeni $ <br /> X AURTOs ONLY AF1T0'W P p uldM GE $ <br /> UMBRELLA LFAB OCCUR EACH OCCURRENCE <br /> EXCESS LIAR CLAIMS-MADE AGGREGATE S <br /> DIED RETENTION$ <br /> B WORKERS COMPENSATION X PER L OTH- <br /> ANDEIYIPL©YERS'LIABILITY YIN 019640672 04/0112018 0410112019 500,000 <br /> ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT S <br /> oFFFICElMp1M EXCLUDED? NIA i <br /> {Mande ory n E.L.DISEASE-EA EMPLOYEE S 500,000 <br /> If yes,describe under 5300,000 <br /> DESCRIPTION OF OPERATIONS below I I t E.L.DISEASE-POLICY LIMIT <br /> A Cargo TCP0001375.00 04/01/2018 0410112019 Per Truck 100,000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedula,may be attached If more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange Count THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 9 y ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough,NC 27278 — f <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016103) O 1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />