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DocuSign Envelope ID:876AD9F4-8OE8-4EOE-8D72-4AF651E99D75 <br /> .4 fz ' EI T1Fi TE F Ll ►81L�7 IN # h1 -+ DATINpa'DUffyj ' <br /> +E i OJD 112♦3 18 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO FLIGHTS UPON THE CERTIFICATE HOI-LIER. THIS <br /> CERTIFICATE ODES KOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTt;R THE COVERAGE AFFORDEb BY THE POOCIiE8 <br /> BELOW. THns CERTIFICATE OF INSURANCE DOE$ NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN!I WRERfS). AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: tf the cerdficate holder is an ADDITIONAL INSUREDr the pWicy(fas)murt be endorsed. It SUBROGATION IS WAIVED,Subject tD the <br /> terms arld condi#ions of the Policy, certain Polieiea nay Tequire an endorsomeflt A S#8iemew on this oartlfir,� does "t confer right=, to the <br /> eerlHficate holder in lieu of such endomemerrt(s), <br /> ooaleF;R Greg Lopemanr CP U aw .F Gre Lp ernan <br /> 9 <br /> State Farm InsuranCC P"4H¢ :9i�� -��70 <br /> arc.w 9 $ 7773 <br /> 104-B NC Hwy 54 VV UMR Gresl,I apeman-k+iY3� St tefann-o�m <br /> arrboro, NC 27910 S]"KKJ qNC CO%TkA— NMr s <br /> INSUI A;SWa a Farm Fire and CasualFr Corn rry°' ,_''R ' R[�EY SURVEYING PA IRSL�F72B:S#ata T57#i <br /> Farm.Mut-I AularncE!tlnsuranc Cam <br /> TE 1003 MURERC: <br /> 3326 DUPHAM CHAPEL.HILT.BLVD MURgRo: <br /> DURHAM NO 7707-2695 IISURERE: <br /> INBgRER F: - <br /> COVERAGES CERTIFICATE NUMBER, REVISION NUMBER: <br /> THIS 1$TO CERTIFY THAT THE f'OLFCIES OF INSLFRANOE LISTED BELOW HAVE ECEN ISSUED TO THE INSURED NAMI LV ABOVE FQI;THE POL" PERIOD <br /> INOICATEO, NOTWTI`-CST,4NDIN'C; ANY REQL)PREMENT, TE;KM-0 OR CONDF ION OF ANY CONTRACT OR DTHEp DOCUMENT WITH RE4QPf=CT TO NIC#I THIS <br /> CERTIFICATE MAY EE 18SUED OR MAY PERTAIN, THE INSURANCE RfFC4ME8 F3Y THE POLICIES DESCR*W HEREFN Ig SLIB,IECT TO ALL THE TERid$, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES-LIfAITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLNM5. <br /> 7FTR ADaL <br /> TR F#* <br /> 7TPE#iNSLI1i�,►pY ��, ...� PPlIC7r 7tI�T EAP LIMUTa . <br /> tt IEAAJ. UWaMa y ❑ 4 'GG 5$ 0712012ma 02f2012019 EACIIOCCURRIINCE 3 1.004000 <br /> 36AMCRIgL CENE#t4L 41,rgILnY <br /> PREMISr j goeun*r l S 300,00a <br /> CLAIMSWDE FxR1OCCLIR I Mid ESuP(carry aw rson} 7 5,040 <br /> PERGOINArL&AOVINJURY $ t,Otl¢,04d <br /> — GIErERALAGGFIE qTE $ {i0Q,0U0 <br /> CEML AGGPE6AiE LIMIT APPLIL'S PEk <br /> P"0U JCTS-UWPPDP AGG $ 2,000,i)U0 <br /> JALIMBRELLALIA3 <br /> f t.OG <br /> S <br /> L�ABLItY OT1971A-D30-33 0�4IM2ot8 0�4f3afmm Iw$as�w€�Let rT <br /> TO DOL11LY INJURY(Per Pei ) S �.J54,404 <br /> ALLaF4 SHEDULEO <br /> AUTOS AUFCS E44CNLY wJURY fRnr aorJq$nI} $ 500,000 <br /> UTOS t�4F�OWFd=d _ <br /> ALJTQ$ ��8otidmtl�{ E S 740,�U0 <br /> 8 <br /> IA3 x OCCUR <br /> rgQfB G91t4f2g19 II°Cc WE s t.000.0 0EXCESS L.I CLAIMS-FAADE RETEF(ftpNS 10000 -- <br /> 4JORKER$GUWE lSATW <br /> AND$MPLOWEAV LVOILITY WG STATU6 <br /> 0 PROr'MBER XCLU E F_K£CiJrrVE TrK E:.L.EAGIaACC10€FfT 5 i3Ogp,000 <br /> ptanda r!fin EJEXi:LUpED'+ NIA 93-CV�S5T-5 02120120Y8 D212I>�2V19 <br /> iM�ntlatpry yI NFQ <br /> r yeS,rJcre Ibaunda+ C.L❑ISEFSE-EAEMPL OF CH31CRATI <br /> Y t.004,400 <br /> GL,MEASE•P 30eUNff S •• 1.�04,04U <br /> 13E3GRIPTt6NQF{IY1FLA7k0N5fLOCA.110o-rg0VEHICLrS FAtWhAGWb101,Add1151 e1Rbn-*rho-3dirduEs,rrriarewac isnmiulrirq <br /> CERTIFICATE HOLDEN CANCELLATION <br /> Orange County SHOULD ANY OF T"E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE ExP�ATIDti as E TF{EREOIF NOTICE 4YILL eF DELIVERED IN <br /> PO Box 8181 ACCORDANCE mrrl THE POLICY PRovISIO NS. <br /> Hillsborough, NC 27278 <br /> A F?FMEgEkTALTI <br /> Y988 D ACQf2f}CORPORATION- +411 rights reSerYCd- <br /> ACORD 25;�0101D5) The A CORD name and IogQ are registers marks of ACORp 1CO148fi 1 3 4g.$ 11-15 2010 <br />