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DocuSign Envelope ID: F8057E6E-3837-4DFE-AEF9-BD8F83298798 <br /> -- .,. <br /> CERTIFICATE OF LIABILITY INSURANCE °"TE 0812n/19 <br /> Dsrnsrzol s <br /> THIS CERTIFICATE 15 ISSUED A5 A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 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- It the Certificate holder is an ADDITIONAL INSURED,the pollcy(ies)must he endorsed, It SUBROGATION IS WAIVED,subject to the <br /> terms and conditions of the Policy, certain policies may require air endorsement- A statement on this certificate dc)" riot confer rights to the <br /> certificate holder In lieu of such andarsemunt(s). <br /> PRDnuCER Greg LOpeman, Cl'CU CONTACT - <br /> NAME _Greq Lopeman <br /> State Farm Insurance PI40NC <br /> uuc.xa.-I�1n_ 1 3777�_ ____Finrc.tb 1 MIZ 13 <br /> LAIAIL <br /> a104-B NC Hwy 54 W Agbgss:Greg,Lopeman.WSL&Statelarm,com. <br /> CarrSaro. IBC 27510 INSU"_A( AI:EOROINGCOVERAaB_ rf�ucll <br /> INSURER A;State Farm Fire and waft Compj3 S <br /> IrlsuRCD RILEY SURVEYING PA 'lull.B:State Eerm Mutyal Automo_6iig-Inmrance Company 517E <br /> STE 100B INSUMERC: <br /> 3326 DURHAM CHAPEL HILL BLVD INSURERD' <br /> DURHAM NC 2(707-2695 INSURER F-- <br /> INsufIER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> I HIS 1S TO CERTIFY THAT THE.POLICIES OF INSURANCk 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 BE ISSUED OR MAY PERTAIN, IHL INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUaJECT TO ALL THE TERMS, <br /> EXCLU_$IONS AND CONDITIONS[If-SUCH POLICIES-LIMITS SHOWN MAY HAVE BEEN REDUCF0 BY PAID CLAIMS. <br /> LTR TYPE OF ANcE 1.SUBR FOLIC Y POLICY E7IP <br /> P'CXICY NUMBER Dr(Ms LIMITS <br /> A LIASKM Y 93-CG-ZO05-8 02120r2019 02n=020 EnCri gCc ultNt NCE ; 1.000.000 <br /> CDAffAF:RCIAL GENERAL LIABILITY <br /> F I�tEAES I oex_urrnnne7_ 3DORDO <br /> CLAIM1t`rI/Ar1Ebl� OCCUR HIED DCi (Ary Orri Pefeun) S _5,000 <br /> i PERSONAL A ADV INJURY S 1.000,000 <br /> GENERAL AGGRFGAtE T 1: 2,0w,000 <br /> GENL ACHMOATE L kff APPLIFR PER PRODUCTS COMPrOIIAGG S 2.000.000 <br /> x POLICY mr10C - <br /> B AIITOIIOBILELIADIL]rY 071 9714-D30-33 1013OJ2018 1G13W2019 Ee COMUINLD LIMY 3 <br /> ANY AU IO BODILY INJURY ltrnef Per TALL 3 500 <br /> ,000 <br /> AUTZ)S rD x OS SCHEDULED OCOrLY IE;A„IRY(Par oomdorrl) — <br /> HOH-DVIHFD $ 500,000 <br /> HIRE❑AUTOS EX <br /> AUTOS rZErxx._r S 100.000 <br /> A U/IBRELLA 1JAB X GCCUR - ' L <br /> 93-GM-1111-1 1 Oarf01201ES Oar1D1z019 rAaHoccLaRa[Ncr S 1.000,000 <br /> "ICEM 9_ U" - CLAIMS-MADE AG(;PEGATE S 1,000.000 <br /> OFU 1 x RLTLNIHINS 1000.0 S <br /> A WORK CRS COMPFIFISATION - VVC S 1A I U OTIF <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPR1ETpRIPAA INfRer_XECUTIYC YIN IEL.EACH ACE:@i I OF S 1,000,000 <br /> F'tCIiWMB EHEXCLUDED: NIA 93-CVR463 <br /> Y❑ - -3 02/2012019 M012020 <br /> INIae I I ry In NMI E.L.OMrASF.EA ELO Mr' YE s 1,000,0f10 <br /> R yea,descrlto umm -- _- <br /> _ _ E.L DISCASF.POLICY LIf,117 I S 1.000,000 <br /> DESCRIPTION OF OPLRATION8 0 LOCATIONS I VEHICLES IAIIxh ACORD 101.AdW Ronal Roma."Sched,.la,Ir mere swco is rngcuredy <br /> CERTIFICATE HOLDER CANCELLATrrION <br /> Orangle County SItOULD AI0 Y OF THE A1IOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE rXPIFZATION DATE THEREOF, NOTICE WILL BE DELIVERED 1N <br /> PO BOx 8181 ACCORDA CE VY1TH THC POLICY PROVISIONS. <br /> Hillsborough, NC 27278 t <br /> AU►1.OR[ZED REAMENTAXM <br /> � p <br /> 01988-2010 ACORO CORPOt4AT ON, All rights resealed. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 1001,P35 132849.6 11-15-7010 <br />