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DocuSign Envelope ID: 1137F6E0-DEB3-49DB-96A7-532CBC37EDAE <br /> DocuSign Envelope ID:E01C0794-A545-4319-A558-3A8224933F92 jkitachment <br /> •�� ® CERTIFICATELIABILITY INSURANCE <br /> DaTEtMMrobrmrv) <br /> 11t16t2018 <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 INSURED($), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must have ADDITIONAL INSURED provisions or he 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 ri hts to fhe certificate bottler in Lieu of such endorsement(s). <br /> PRODUCER CONTACT Jami McMillian <br /> NAME: <br /> Stale ail GARY ELLIOTT PHONE 919-942-6057 JFAX 919-968-1948 <br /> AIC.No. <br /> o Ext• A!C No <br /> ? 1805 E.FRANKLIN ST.5TE 210 ADDREss: Jami@chapelhiilsf.com <br /> CHAPEL HILL,NO 27514 <br /> INSURER 5 AFFORDING COVERAGE NAIL# <br /> INSURER a State Farm Fire and Casualty Company 25143 <br /> INSURED INSURER e: <br /> KEENAN WILLIAMS INSURER C; <br /> 730 EAGLE POINT RD INSURER➢; <br /> PITTSBORO,NO 27312-6176 INSURERE: <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 /> ILTR TYPE OF INSURANCE ADDL S BR P EFF POLICY EXP <br /> POLICY NUMBER MMLVDMIODlYYYY) (MMn)DNMI LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> AMAII To <br /> CLAIMS-MADE ®OCCUR PREMISE S Ea oNcu ante $ <br /> MED EXP Any one person) S <br /> 93-CV-PO69-5 09/11/2018 09/11/2019 PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIESPER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY❑PRO JECT 1:1 LOC PRODUCTS-COMPIOPAGG $ <br /> OTHER: S <br /> A COMBINED SINGLE LIMIT <br /> AUTOMOBILE LIABILITY $. <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEC) RETENTION$ $ <br /> WORKERS COMPENSATION ER STATUTE HRH <br /> AND EMPLOYERS'LIASILFrY <br /> ANY PROPRIETORIPARTNFR/EXECUTIVE YNIA EL:EACH ACCIDENT S <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ <br /> if as,describe under <br /> DESCRIPTION OF OPERATIONS below IE.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS t LOCATIONS I VEHICLES (ACORD 101,Additionaf Remarks Schedule,may he attached if mare space Is rectufredl <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 /> AUTHORIZED RESENTATNE <br /> HILLSBOROUGH,NC 2727B <br /> 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> 1001486 132849.12 03,10-2018 <br />