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DocuSign Envelope ID: F6E5B15D-6611-4749-BBCF-56530F14FFBD <br /> AGENCY CUSTOMER 1D.35SMEINC <br /> LOC#: <br /> '4�o ADDITIONAL REMARKS SCHEDULE page 1 of 1 <br /> AGENCY NAMED INSURED <br /> BB&T Insurance Services,Inc. S&ME Inc. <br /> 3201 Spring Forest Rd. <br /> POLICY NUMBER Raleigh,NC 27616 <br /> CARRIER NAIL CODE <br /> EFFECTIVE DATE: <br /> ADDITIONAL REMARKS <br /> THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, <br /> FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE <br /> would he provided with notice of cancellation of the policy. <br /> Project:Orange Cc-Hillsborough PRLF(Project No.4305-17-061) <br /> Orange County,North Carolina Is Included as Additional Insured with respect to General Liability and Automobile Liability Coverage.Umbrelia Liability Is written <br /> on a Fallow-Form basis over the underlying General Liability,Automoblie Liability and Employers Liability policies.Professional Liability includes Can tractors <br /> Pollution Legal Liability and Is written on a claims made basis.Certificate holder Is additional insured for Contractors Pollution Legal Liability if required by written <br /> agreement,but solely to the extent that the INSURED'S liability arises out of Contracting Services rendered by or an behalf of the NAMED INSURED. <br /> ACORD 101 (2000101) C 2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />