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DocuSign Envelope ID:98D934B1-A47E-4D2E-9271-18CDFA20A1AD <br /> •a CERTIFICATE ATE E LIABILITY INSURANCE dATEID1!2lr18 <br /> Y Cl41?2018 <br /> THIS CERTIFICATE is ISSUED AS A MATTER OF tNFOR A710N ONLY AND GONJ"ERS J40 REGHT9 tlPON THE CERTIFICATE HOLyyyyj <br /> OCR. THIS <br /> CERTIFICATE DOES KOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTE14EI OR ALTER THE COVERAGE AFFORDEn 13Y THE POOCEES <br /> BELOW. THI'S CERTIFICATE OF INSURANCE DOES NOT CONSTFUTE A CONTRACT BETWEEN THE ISSUING I6lSURER($), A.LrrHORJZED <br /> REPRESENTATIVE OIL PRODUCER.AND THE CERTJFICATE HGLdER. <br /> IMPORTANT: tf the certificate holder is an ADDITIONAL INSURED,1hO Pnlicy(Eas)must be endorsed, if SUBROGATION Is W,4IVED,subject to the <br /> terms and conditions of the pallcy, certain policlkn may require an endomernent A statement on this certlfirate does not confer rights to then <br /> ceAlf Ecate ho3dar in lieu of such endarsermrlt{s). <br /> PRODUcel? Greg LOpeirl ra, I;p1�IJFQ�'c��G,169 <br /> _Sty# ITBiTT} Insurance 9s .7774 �nc wa!104-B NC Hwy 54 man,NYSL Statafarm-corn <br /> arrboro, NC 27510 S]"FURMFOG egyphA(ir; w,ues <br /> T1+sukeo <br /> INSUFMR A:Stale Fx n%Fine ark Casual {Jom ny Z"43 <br /> RILEY SURVEYING PA �resu�xe=stars Farm t�utuat Awomabib rnsur�r,ce-Gom <br /> e <br /> TE 1003 UkSLaaERC= <br /> 3326 DURHAM CHAPEL.HILT.ELVD INSURER D: _ <br /> URHAM NO 27707-2695 II uWKERE= <br /> n76URER F: - <br /> COVERAGES CERTIFICATE NUMBED= REVIS CIF1 NUMBER:THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED OJELOVV HAVE ECEN ISSl1Ep TO THE IN URED NAhtI�p ABOVE FOR THE POL" PERM <br /> INDICATED, NDTWITHSTANI)IN', ANY REQUIREMENT. TE IRM OR CONDMON OF ANY CONTRACT. OR OTHER DOCiJME�N7 WITH RESPFCT TO WHICH THIS <br /> CERTIFICATE MAY ICE 18SUED OR MAY PERTAIN. THE iNStJJ3AK:F AF�FC4MEJ) eY THE POOCFES DE$CtR*W HERE�I`N JS SUBJECT TO ALL THE TEMA.t . <br /> EXCL USIONS AND CONDITIONS OF SUCH POLICIES-LIfAITS SHOWN MAY HAVE BEEN REDUCER BY p_AID CJ.AIMS- <br /> 5;im AD13L 8 <br /> 7R 7TPE OF if15lA2AY POLICY <br /> r8E17 FPlFC7'Ef$ P�71.ICT - <br /> 'a r�+ERALLIPANLn'Y Y 9� CGL005$ 07J'7Df2mU o7120J2079 EACHOCCURRIINCE 3 1.000.003 <br /> COMMERCIAL GEHFl7AL wmi-rrY <br /> i MELOSrS�kaopwnarKa S 300,J]00 <br /> CLAJMS-µadE OGCLRi hid ESup(Arq orw ersrn) S.000 <br /> PSR80HAt8ADVINJURY S tAD4,000 <br /> GENER OLLAO LYE $ J]OQ,Ogq <br /> CEtTL AGGREGATE LM17,eyPLICS PM �y <br /> F%tO�UCTS-L.UMPfC1P AGG S 2,CN)O DDO <br /> X i POLrGv 1-00 <br /> z <br /> $ ,wrD IrY 071 9714-D3a-23 Da�0rz0is 04f30�u79 iryEed$IkGLE>.wiFr IsALi <br /> ALL A OM1UTO DO LY kNJLJRY EPer P�+n] S 5rJ4,d04 <br /> 1'r'�4 SCHEDULED <br /> AUTOS 1,10WO 130INLY INJURY(Per aDcKent) $ 500,000 <br /> HFrzEdAUT05 LFI-05YMCD - <br /> A4r'rQ$ lO�$tidmtl � E S 100,000 <br /> S <br /> {{ UMBRfL1,+.t.rR6 �{ OCCUR <br /> 93�M-Y111.1 08110t2018 1)8H0f2019 EACHOCCI-I NCE t.000OQq <br /> ���'�-L4e CLAIhas-r,6apE Li <br /> AGGREG4-M S 1,J]0Q-000 <br /> aED r HET WWNs 10OUO <br /> WORKERS 00W9VATWN � <br /> AND EMPLOYEpVURUFLrrY WGSTA3U• OT}L <br /> ANY PRQVI4PEETfllbPA1RTN itiF_K£W7-ME Y e N <br /> OFIMME5MBEREXCLUIDEM Y NPA 93-CV4457v D2II20,2018 021�Ui�019 >=:L-EAT " CLt0ENT € i,00A,Coo <br /> ir��.d�tary In wlq . <br /> tLree,rJcxenbas�nde• E.L-❑!5EA3E-EAEMFL 1-0w.000 <br /> OF <br /> G1.LMSEASE•M3CL Y LIN f $ 1-000.000 <br /> DERCPJPTIOH OF OPEFW76DN5 J LOCA"XIS I VEHKI-rB IAtWh ACORID 101,Addldo t Rwwhr Sduduck it mum wac is m,µuired] <br /> CERTIFICATE HOLDEN CANCELLATEON <br /> Orange COt111Ly SHOULD ANY OF THE ABUVE DESCRIBED POLICIES BE CAN CEL>_ED BEFORE <br /> THE EXPERATJON DATE THEREOF. NOTICE WILL BF DELFVEREID IN <br /> PO Box 8181 ACCORDANCE WFTrl THE Pot3CY PRovISIONS. <br /> Hillsborough, NO 27278 <br /> A ;wwrks <br /> 8 0 ACOR2D 00 RPORATION- AI I rights reserved- <br /> ACORb 25;20101D5} TheACORD narne and are regist$ ofA 3RD 1041486 132849.6 11-1r)--2010 <br />