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DocuSign Envelope ID: EFOF4850-10E3-41OF-98DB-CFFA02CD2335 <br /> �0� DATE(MMlDDlYYYYJ <br /> A <br /> CERTIFICATE OF LIABILITY INSURANCE 11/16/2018 <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 poilcy(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 endorsement(S). <br /> PRODUCER CONTACT Jami McMillian <br /> NAME_ <br /> StateFarm GARY ELHOTT we°Ne E . 919-942-6057 FAXIA(CNo: 919-968-1948 <br /> • 1806 E.FRANKLIN ST.STE 210 E-MAIL jami@chapelhiilsf.com <br /> • <br /> CHAPEL HILL,NC 27514 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURERA: State Farm Fire and Casualty Company 25143 <br /> INSURED INSURER B: <br /> KEENAN WILLIAMS IN5URER C: <br /> 730 EAGLE POINT RD INSURER D: <br /> PITTSBORO,NC 27312-6176 INSURER IS: <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 TYPE OF INSURANCE ADDL SUER POLICY NUMBER MOIDDY EFF NYYYY MM1OAILDICY LIMITS <br /> LTRINSn vim <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11,000,000 <br /> DAMA E T RENTED <br /> CLAIMS-MADE OCCUR PREMISES Ea occurrence $ <br /> MED EXP(Any one person) $ <br /> 93-CV-PO59-5 09/11/2018 09111/2019 PERSONAL&ADV INJURY $ <br /> GEN'L AGGREGATE LIMIT APPUESPER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY E PRO LOC JECT PRODUCTS-COMPIOPAGG $ <br /> OTHER $ <br /> BIGLE LIMIT <br /> AUTOMOBILE LIABILITY CO EaMNED SINGLE $ <br /> ANYAUTO HOOILY INJURY(Parperson) $ <br /> OWNED SCH <br /> AUTOS ONLY AUTOSEDULED BODILY INJURY(Per accident) $ <br /> HIRrD NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED RETENTION S $ <br /> WORKERS COMPENSATION <br /> OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE R <br /> ANY PROPMETORIPARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ <br /> OFFICERIMEMBER EXCLUDEd? <br /> [Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> CESCRiPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS)VEHICLES IACORD 101,Additional Remarks Schedule,maybe attached it 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 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO BOX 8181 4-1 <br /> HILLSBOROUGH,NC 27278 AUTHORIZED R TATIV�ESnENnE <br /> 1988-2015 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD <br /> 1001486 132849.12 03-16-2016 <br />