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DocuSign Envelope ID:6B6FDE8C-BB7C-4270-8B4F-E2FEA17AA582 <br /> AIR©� CERTIFICATE OF LIABILITY INSURANCE [7iiiis/qnia <br /> EfmptoITHIS <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDECERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PBELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTH 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 SUBRO13ATION IS WAIVED,subject to the terms and conditions of[he policy, certain policies may require an endorsement. A statement on <br /> this certificate does_not confer rights to the certificate holder In Ilea of such endorsements. <br /> PRODUCER Cb TACT Jami McMillian 5 NAME' <br /> Later-.Jr'� GARY ELLIOTT PRONE 919-942.6Q57 FAX 919-988-1948 <br /> M 1805 E.FRANKLIN ST.STE 21D grtc.Ne>xlY — °JC - <br /> � E-IUTAwrL Jarrli(�chapefhlllsF.com <br /> CHAPEL HILL,NC 27514 <br /> INSLiRER S AFFORDING COVERAGE NAIL p <br /> —INSURED INsuR€R A: State Farm Fire and Casualty Company 25143 <br /> KEENAN WILLIAMS INSURER B: <br /> 730 EAGLE POINT RO INSURER C <br /> PITTSBORO,NC 27312-I3176 INSURER O <br /> INSURER E- <br /> rNSGRER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:THIS IS TO CERTIFY THAT THE POLICIES OF INS 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 /> ILYR TYPE OF INSURANCE DD SUeR POLICY EFF POLICY EIIP <br /> POLICY NUMBER MfOD MMroDfYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY <br /> EACH OCCURRENCE ; 1,000,000 <br /> CLWMS-MAQF �OCCUR RE <br /> PREMISES Be uccu nw S <br /> MED EXP one rsorr 5 -- <br /> 93-CV-PO59-5 051111z018 0911 112019 PERSONAL&ADV INJURY _ s <br /> GEN'L AGGREGATE LIMpprrAPPLIES PER: OENEF+J,L AGGREGATE $ 2,OQD,QQO <br /> POLICY JEC7 ❑LOC <br /> OTHER- PRODUCTS-COMP/OP AGO, S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANYAITTO a accident <br /> BODILY INJURY(Fe person) <br /> S <br /> j;m <br /> SCREDULEO <br /> AUTOS BODILY INJURY(Per acdclent) S <br /> HIRIAUTONON-SNNBY PROPERTY DAMAGE <br /> AUTOSAUTOS ONLY Per accident S <br /> $ <br /> OCCUREACH OCCURRENCE S <br /> CLAIMS-MADEAGGREGATE s <br /> ETENTION$ <br /> WORKERS GOMPENSAnoN $ <br /> AND EMPLOYERS'LIABILITY PER OTH- <br /> ST TUTS ER <br /> ANY PEWEM5ERIPARTNERJFXECUTIYE Y 1 N E.L.EACHACCIOFNT $ <br /> (Mandatm In BER ESfCLUi]EDT N l R <br /> [Mandatory In NR) <br /> If yes.da%Mia under E.L.DISEASE-EA EMPLOYE $ <br /> DESCRIPTION OF OPERATIONS belay E.L.DISEASE-POLICY LIMIT S <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Addillonal Rarnaft Schedule,may be attached a morn space#s requf■edl <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 /> HILLSBOROt1GH,NC 27278 A7EI988-2016 <br /> ATIVE <br /> .�.a. <br /> ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORA <br /> 1O7I486 i3294.9.5�03.7e-2p38 <br />