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DocuSign Envelope ID:414D9BA4-13B6-4028-9E47-ED6DOA945D55 <br /> ® DATE(MMIDDfYYYY) <br /> ACORV CERTIFICATE OF LIABILITY INSURANCE <br /> 0610412019 <br /> THIS CERTIFICATE IS ISSUED AS 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: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsements. <br /> PRODUCER CNAOME:NTAC CELESTE WILBURN <br /> StateFarm MICHAEL HALLER PHONE 919-552-4196 FAX No: 919-552-0405 <br /> Extk <br /> 1536 N.MAIN ST Ep AIL CELESTE.WILBURN.HZJL@STATEFARM.COM <br /> FUOUAY VARINA,NC 27526 <br /> INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A: STATE FARM INSURANCE <br /> INSURED INSURER B: <br /> E,P,1.C.ELECTRIC,LLC INSURER C: <br /> 188 SCOTTS CREEK RUN INSURER D: <br /> ANGIER,NC 27501 INSURER E: <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 BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR TYPE OF INSURANCE POLICY NUMBER MMlDDIYYYY M /DQ <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 <br /> ED <br /> CLAIMS-MAOE EOCCUR PREMISES Ea oocurrence $ <br /> MED EXP(Any oneperson) $ 5,000 <br /> A 93-EA-Y385-0 06/22/2018 06/22/2019 PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4,000,000 <br /> POLICY❑PRO ❑LOC PRODUCTS-COMPIOPAGG $ <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE OMIT $ <br /> (Ea acadant <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS ONLY AUTOS <br /> HIRED NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per acci ant <br /> I r a <br /> UMBRELLA LIAB Ll OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> OED I I RETENTIONS $ <br /> JWORKERS COMPENSATION PER OTH- <br /> ANDEMPLOYERS'LIABILITY STATUTE ER <br /> ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ <br /> A OFFICERIMEMBER EXCLUDED? N 1 A 93-EA-Y464-7 06122I201 B 06/22/2019 E.L.EACH ACCIDENT $ 144,400 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE S 100,000 <br /> If yeSCRIPTION OF OPERATIONS below s,describe under E.L.DISEASE-POLICY LIMIT $ 544,400 <br /> DE <br /> DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Additlonal Remarks Schedule,maybe attached if more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ORANGE COUNTY ANIMAL SERVICES ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1601 EUBANKS RD <br /> AU RIZEQ REPRESENTAU" TIV <br /> CHAPEL HILL,NC 27516 f <br /> I �L�- - <br /> ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD <br /> 1001456 132849.12 03-16.2016 <br />