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DocuSign Envelope ID:31076302-5D08-411F-A321-680354A900D1 <br /> Created on: Friday, February 1 st, 2019 at 11:18AM <br /> ac V CERTIFICATE OF LIABILITY INSURANCE BATf(LMlBBnmrrl <br /> 02ro1/2019 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BOLDER. 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 tho certificate holder is an ADDITIONAL.INSURED,the policy(ios)must bo 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 endorsemont(s). <br /> PRODUCER CONTACT <br /> NAME_ Phillip Mike Garrisan,___•_ <br /> Mast&Garrison,Inc, PHONE FA�I <br /> ,VC..nQ,Emi,336-226A474— ________ j FaA ,Not..336-226-4535•__ <br /> 439 South Spring StreetE-MAIL <br /> P.o.Box 340 AooREss: anagins@u mindspring.rertL_—_.-.--- <br /> Burlington,I IC 27215 1 N SURERI 5)AFFORDING COVERAGE -___ NAICA <br /> _-- - — - -- INSURER A:.&.dts-dale-l%uirance._Qompany--•-....-------- 97 <br /> INSURED INSURER 8 <br /> ENSURER C; <br /> Hoo€Beat Farm LLC INSURER0; <br /> 2401 NC 57 INSURER s; <br /> Hillsborough NO 27278 <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 RE ISSUED OR MAY PERTAIN, THE INSURANGE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT To ALL THE TERMS. <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LTR �.�-.TYPE OF INSURANCE A B oLicY OFF POI_IDY IE%P LJMM -.. <br /> POLICY NUMBER MMlOOlYYYY MMleWYYYY <br /> pENERALLfABILITY CPS2949864 01/06/19 01/06/20 EACFIDCCURRENCE IuKtriltu S, ODO <br /> AX_T COMMERCIAL GENERAL LIAMUTY PjtELAISFS t occur enue} s�00„Q4] <br /> CLAIM$-MATTE. RI OCCUR MED EXP(Any one person) S 55 M <br /> PERSONAL&AOV INAIRY ... S_1 00_0,0 Q___ <br /> GENERAL AGGREGATE 52,9QQ,.sas+Q— <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMPIOP AGO <br /> POLICY PRO- <br /> --- LGC S <br /> _ (ES <br /> ABIIN SINGLE LIMIT CCid0W5 <br /> AUTOMOBILE LIABILITY <br /> ANY AVTO MOIL.Y INJURY Fu person)- 5 - _ .._.. .. <br /> --• ALL OWNED SCHEDULED e001LY INJURY{Per accl&nq 5• - <br /> H REAAUfOS NON-OWNED PROPERTY DAMAGE S <br /> AUTOS eracadenl) _------__-- <br /> $ <br /> UMBRELLA LIAR HOCCUR I EACH OCCURRENCE S <br /> EXCESS UAB CLAIMS-MADE AGGREGATE $ <br /> OCp R ETENT1ON 5 $ ----- <br /> WORHERS COMPENSATION Vk STATU- OTH- <br /> ANU EMPLOYERS'DABILITY YIN T,pi;Y_LIMLT.B. ".. E8" <br /> ANY PROPRIETCWPARTNERIEKECUTIVE NIA F.L.,EACH AOCIOENT S <br /> PFFICERIMEMBERFXCLUBEB7 ❑ - -""------ —"------ <br /> lMandefory In NH] E-L.OISEASE•EA EMPLAYE 5 <br /> if yyes,dm4be under _._.....n..._. _....."_..._--- <br /> L]ESCRIPTION OF OPERATIONS balaw E.L.DISEASE-POLICY LIMIT 5 <br /> DESCRIPTION OF OPERATIONS;LOCATIONS I VEHICLES(ALgch ACORD 101,Additional Remarks Schedule,If moro space le roqulrod) <br /> Snow Plowing&Landscaping <br /> CERTIFICATE HOLDER CANCELLATION <br /> ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBE POL10ICS BE CANCELLED BEFORE <br /> PO BOX 8181 <br /> )$ THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Hillsborough, NC 27278 <br /> AUTHORIZED REPRE SENTATJVE <br /> ©1988.2010 ACORD CORPORATION, All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />