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DocuSign Envelope ID:5BB79893-2A98-4C27-B3FC-097C7EB5D41 E <br /> A QR(J� CERTIFICATE OF LIABILITY INSURANCE F <br /> DATE IMMIDDIYYYYIsrs1za16 <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(€es)must be endorsed. If 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 endorsements. <br /> PRODUCER CONTACT Heidi Morse _ <br /> }ones Insurance Agency Inc. PHONE FAX <br /> 820 Benson Road 919-772-0233 919-779-4025 <br /> Garner NC 27529 -ADD SS:heidim@Jones-insurance_com <br /> INSURER 5 AFFORDING COVERAGE NAIC p <br /> INSURER A:Cincinnati Insurance Company 10677 <br /> INSURED PENNDAV-01 INSURER B,Builders Premier Insurance Co 13036 <br /> Penn Davis Coatings, Inc. INSURER C: <br /> P 0 Box 575 <br /> Garner NC 27529 IN-SURER D <br /> INSURER E <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER:1551488639 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 AUUL TYPE Of POLICY EFF POLICY EXP LIMITS <br /> LTR SD WVD POLICY NUMBER MMIDDIYYYY MMMDJYYYY <br /> A X COMMERCIAL GENERAL LIABILITY F-PP0226481 1/25/2016 1/25/2017 EACH OCCURRENCE S1,000,00o <br /> DAMAGE To RENTED <br /> CLAIMS-MADE n OCCUR PREMISES f a occurmwo $500,000 <br /> MED EXP(Any one S10,000 <br /> PERSONALkMVINJURY $1,000.000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $2,000.000 <br /> ---- POLICY X JECT - LOC PRODUCTS-COMPIOP AGG $2,GOO,000 <br /> - — <br /> OTHER: $ <br /> A AUTOMPBILELIABIUTY EBA0226481 11251201E 1/2512017 _COMBIidercFj NED I $1,000.000 <br /> X ANY AUTO <br /> g y BODILY INJURY(Per parson) $ <br /> Al 7p$ ED AUTOSULED BODILY INJURY(Per accident) $ <br /> k HIRED AUTOS x NON-OWNED PROPERTY DAMAGE $ — - <br /> AUTOS Per acddent <br /> $ I <br /> A k UMBRELLA LIAB k OCCUR EPP0226481 1/2512016 112512017 EACH OCCURRENCE $5,000,000 <br /> EXCESSLIAB CLAIMS-MADE AGGREGATE $5,000,000 <br /> DELI k fRETEWION$0 $ <br /> B WORKERS COMPENSATION PWC 0020810 17 1/112016 111/2017 x STER ATUTE ERH- <br /> AND EMPLOYERS'LIABILITY Y I N <br /> ANY PROPMETORPARTNERIEXECUTIVE E.L EACH ACCIDENT $1,000,000 <br /> OFFICERIMEMEER EXCLUDED? M NIA - <br /> (MandatorylnNH) E.L.DISEASE EA EMPLOYE $1,000,Coo <br /> II yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 57,000,000 <br /> A RentedlL®ased Equipment EPP0226481 1/25/2016 1125/2017 Llmil ACV 80,00o <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,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 County THE EXPIRATION [SATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> PO Box 8181 ACCORDANCE WITH THE POLICY PROVISIONS, <br /> Hillsborough NC 27278 <br /> AU ORVED REPRESENTATIVE <br /> O 1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD <br />