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DocuSign Envelope ID: E01 C0794-A545-4319-A558-3A8224933F92 ti dachment B <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDTrM) <br /> 11/16/2018 <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($), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the poiicy(ies)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 CONTACT Jami McMillian <br /> NAME: <br /> StateFarM GARY ELLIOTT PAIICONe Ext. 919-942-6057 a No: 919-968-1948 <br /> 1805 E.FRANKLIN ST.STE 210 AoAIL <br /> � ESS: jami@chapelhillsf.com <br /> CHAPEL HILL,NC 27514 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURERA: State Farm Fire and Casualty Company 25143 <br /> INSURED INSURER B: <br /> KEENAN WILLIAMS INSURERC. <br /> 730 EAGLE POINT RD INSURER D: <br /> PITTSBORO,NC 27312-6176 INSURER P_: <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 ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY) (MMID2IYYYYI LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE X OCCUR DAMAGE T RENTED <br /> PREMISES Ea occurrence $ <br /> MED EXP(Any one person) $ <br /> 93-CV-PO59-5 09/11/2018 09/11/2019 PERSONAL&ADV INJURY $ <br /> GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 <br /> POLICY PRO- LOC PRODUCTS-COMPlOP AGG $ <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident, <br /> ANY AUTO BODILY INJURY(Per person) S <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTO S BODILY INJURY(Per accident) $ <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per acciden# <br /> $ <br /> UMBRELLALIAB HOCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION$ $ <br /> WORKERS COMPENSATION PER <br /> AND EMPLOYERS'LIABILITY YIN STATUTE ➢ERH _ <br /> ANY PROPRIETORIPARTNERIEXECUTNE ❑ E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDED? N I A <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD 101,Additional Remarks Schedule,may be attached it more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ORANGE COUNTY ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO BOX 8181 <br /> HILLSBOROUGH,NC 27278 AUTHORIZED RESENTATwE <br /> un�. , <br /> 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> 1001456 132849.12 03•1r-2016 <br />