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DocuSign Envelope ID:6A6B17DA-7C81-4C16-AA4F-2855F76ECDD7 <br /> CERTIFICATE OF LIABILITY INSURANCE UATE(MUM}rYYn <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H LOER.I 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 INSURI=R(SI. AUTHORMED <br /> REPRESI=NTATive OR PRODUCER.AND THE CERTIFICATE HOLDER. <br /> IMPORTANT. If the certificate holder Is an ADOM014AL INSURED,the piollty(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVER, subject to the terms and conditions of the policy,certain policies may require an endorsement A staterrrent an <br /> this crlrtlflcate loos Ilvt ranter lets to the certificate hotdar in Ilhu of such endorsement(s)_ <br /> PRolklCtR C "TA Carla Carrigan <br /> Sbte-'FamI Matt Murphy rruira <br /> - 4710 Counlry Club Rd �'��� _ ���357221fl17 <br /> 1Nrnston Safem NC 27104 A Carla.a caRrgan.hz€r>�Slatefarsn.cotn <br /> >rlsuree sr AF _ VlgfkflE NAK r, <br /> Stale Farm Fire rrnd Ca- uvsluRen A; sly wry 25143 <br /> _�_.. <br /> Feambach History Services Inc ssu m e <br /> 3334 Notringharn Rd <br /> oasltrzFR p <br /> 'uonston Salem Nr,27104 <br /> INsusrl ti <br /> _:. <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUIYIBt;ii: <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. NOT1iv11THSTANDING ANY REQUIREMENT, TERM OR CONDITION Of ANY CONTRACT OR OTHER DOCUMENT VfiAT'H 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 SHdVNd MAY HAVE B[EN REDI}S CD BY PAID CLAIMS. <br /> App'SUER[ .E$`F f.,Pcdi3CYEYP <br /> i'R TYPE OF INSUrtANCE PbLrtY WAtswit - PCtID AN ...� Lrwn.. <br /> U-17ERCIAL GENERAL LIARKM <br /> CACi OCCUfYRFWX S 1,oau.000 <br /> ikW ES <br /> ME-OUP I�N arm Parroni S S,C I) <br /> _ 93-13134672-7 (VIOR018 OW012DIII F? IRstINALaAravlNluHY S - <br /> _GENT Ar.GRECAT[LIIUT APPLES FER; GFtuFiIAL Ai;G€tEGA7E s 2.00fi DijQ— <br /> R'OUCY D JET 0 I.i`C i1 .... <br /> if RK7r�kPCi`.CC,3RlI�NDRRS'a(a• i 2- ,� Y <br /> _ -- -. ._._____.T.,...MCp: <br /> AUTOM089-E LIA.1W'rY G't�lAiJ1NED 1 LF.Lf [ <br /> ,W Y AVTO S <br /> a:1ct$,�tr <br /> C.4idLn WANLY INJURY(PR�rp&=M) � <br /> f AlaTL75❑Ili Y A11TO!1 LFi? _.. <br /> *Ar <br /> I+ N{#+ANES E <br /> BOCMLY]N3N.,'4 Y�F�dr95�m1). <br /> AUTOS01x.Y AUrCS ONLY � PROPEH I^fi LVSI�,a4t,� � <br /> ALsups s <br /> LLA LAM OCCUR I <br /> iJCCLRC:IJGE I S crrle r _ <br /> •I4tAPEIENMON31APFNSATKMi - r� S <br /> ER S'UAF3ttrY 3TAT O H- <br /> fi;?F?7PAIR7Ni�.R71"XI:GIIY'ryE x#N <br /> r}I:MCERAILM8Fr REXCLUCFE3T F frilly E.L.EACH ACC.TFWr - <br /> rMandaAory in NH) <br /> L�.J - . <br /> H yeu tl,s%n la under EL CI E-.FA FJ FKLoY£ S <br /> uESCMPTIONOFnPMAli�,]NS,belnpr �. I- .- <br /> - E.L.drSE ti,sp..•POE ICY LIMIT <br /> {Il f <br /> DESCRIPTION OF OPERATIONS 7 LOCATIONS I VEHnLCS tACOFM 141,Add RtmrRtmrks SHNnd c,eery 3sa R7xRlld f oerw spite it ro'9 1 <br /> Additional Insured; <br /> Urange Country Department of Envtronnte It AgriclMure,Parks and Recreation <br /> PO Box 8181 <br /> Hillshwough NC 2727"181 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE VOLL BE DELIVERED W <br /> Orange Country Department of Emnronrilent AgliwIture,parks ACCORDANCE WITH THE POLICY PROVISIONS. <br /> alit Recreation I --- <br /> — <br /> PO Box 8181 AUTHORUF0RE A <br /> HINSbarough NC 2727"181 <br /> � z <br /> 1D19UU--24M A,CORDICOR✓ OPATIOW All rights reserved. <br /> ACORD 25{201611t3) The ACORD name and logo are registered marks ofACOlia. <br /> :o�lataa 13?!I.i4.12 cet.Istnrtl <br />