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DocuSign Envelope ID: D5386F95-C7D7-4467-802E-832D3E20CE67 <br /> AGENCY CUSTOMER ID;35SMEING <br /> LOC#: <br /> a`�" ADDITIONAL REMARKS SCHEDULE Page T 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 NAIC 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 be provided with notice of cancellation of the policy, <br /> Project:Orange Co-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.Umbrella Liability is written <br /> on a Follow-Form basis aver the underlying General Liability,Automobile Liability and Employers Liability policies.Professianal Liability includes Contractors <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 on behalf of the NAMED INSURED. <br /> ACORD 101 (2008101) ©2008 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />