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DocuSign Envelope ID:3E30BB72-BCBO-4AD5-BE8A-E2D61697B7FE
<br /> __"1 BURKE-1 OP ID.SR
<br /> ,44C74C)`,rrcX CERTIFICATE OF LIABILITY INSURANCE DATE(M6/20 9
<br /> 0811I2019
<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(les)must be 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 endorsement(s).
<br /> PRODUCER CONTACT
<br /> THE YOUNG GROUP OF FUQUAY NAME: The Young Group Of Fuquay
<br /> 411 N Judd Parkway NE,Suite A AI CC, Ext:919a52-8274 c N,: 919-552-4615
<br /> Fuquay-Varina,NC 27526 E-MA[L
<br /> ADDRESS:
<br /> INSURER(S)AFFORDING COVERAGE NAIC#
<br /> INSURER A:Erie Insurance Group 26271
<br /> INSURED Burke Design Group PA INSURER B:Hartford Underwriters Ins.Co. 30104
<br /> Ben Burke
<br /> 12218 Bradford Green Square INSURERC:RLI Insurance Company
<br /> Cary, NC 27519 INSURERD:
<br /> INSURER III
<br /> j
<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 /> INS
<br /> I TYPE OF INSURANCE DU B POLICY NUMBER MMIDDYlYYYY .EFF POLICY
<br /> D�✓Y�Y LIMITS
<br /> GENERAL LIABILITY EACH OCCURRENCE S 1,000,000
<br /> B 71. X COMMERCIAL GENERAL LIABILITY 22SBAVD6060 12/23/2018 1212312019, DAMAGE?PREMISES Roccurrence 5 1,000,000
<br /> CLAIMS-MADE 7 OCCUR MED EXP(Any one person) S 10,000
<br /> PERSONAL&ADVINJURY $ 1,000,000
<br /> GENERAL AGGREGATE $ 2,000,000
<br /> GEN'L AGGREGATE LIM IT APPLI ES PER: ! PRODUCTS-COMP/OPAGG $ 2,000,000
<br /> POLICY PRO LOC $
<br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1000000
<br /> ER acCidBni $ , ,
<br /> A X ANY AUTO 012-2330364 12/2312018 12/23/2019 BODILY INJURY(Per person) $
<br /> ALL OWNED X SCHEDULED
<br /> AUTOS AUTOS BODILY INJURY(Per accident)
<br /> X HIRERAUTO5 XNON-OWNED PROPERTYDAMAGE $
<br /> AUTOS PER ACCIDENT
<br /> 3 E !$
<br /> X UMBRELLALUAB X OCCUR ! EACH OCCURRENCE ;5 1,000,000
<br /> B ' EXCESS LIAB CLAIMS-MADE 22 SBA VD6060 12123120181; 12/23/2019 AGGREGATE €S 1,000,000
<br /> DEC X RETENTIONS 10,000
<br /> WORKERS COMPENSATION I WC STATU- CTH-
<br /> AND EMPLOYERS'LIABILITY ; X T RY LIMIT ER
<br /> B ANY PROPRSTORIPARTNER/EXECUTVE YIN 22WBCRI8597 11/28/2018 1112812019E E.L.EACH ACCIDENT $ 1,000,000
<br /> OFFICER/MEMBER EXCLUDED? ❑ N f A
<br /> (Mandatory in NH) E,L.DISEASE-EA EMPLOYE $ 1,000,000
<br /> If yes,describe under
<br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
<br /> C Professional Liabi CDP0001223 08/04/2018 09/04/2019 Prof Liab 1,000,000
<br /> Ded 2,500
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,[f more space is required)
<br /> CERTIFICATE HOLDER CANCELLATION
<br /> ORANGEC
<br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> Orange County, NC Government THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 131 W. Margaret Lane
<br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE
<br /> ©1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
<br />
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