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A.0 ® DATE(MMIDDIYYYY) <br /> AC� CERTIFICATE OF LIABILITY INSURANCE 1012412019 <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 poiicy(ies)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 /> NAME: <br /> PHONE FAX <br /> ,C No]: <br /> SEAGROVES AGENCY,INC EWAIL <br /> ADDRESS: <br /> PO BOX 1280 INSURERS AFFORDING COVERAGE NAIL# <br /> PITTSBORO NO 27312 INSURER A; NATIONWIDE GENERAL INSURANCE COMPANY 23760 <br /> INSURED <br /> INSURER 13 <br /> FPP 128,LLC INSURER C <br /> C3 Hillsborough,LLC INSURER D: <br /> 128 N Chrurton St INSURER E: <br /> HILLSBOROUGH NC 27278 INSURERF: <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 SUBft POLICY EFF POLfCY up <br /> LTR TYPE OF INSURANCE POLICYNUMBER MMIDWYYYY MMIDDIYYYY LIMITS <br /> COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE s 1,000,000 <br /> CLAIMS-MADE Fx_]OCCUR PREMISES Ea oocunenca s 300,000 <br /> ME EXP(Any one person) s 5,000 <br /> A ACP BPOG 3037759560 06/30/2019 06130/2020 PERSONAL 8 ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY1:1 JECT PRO- � LOC PRODUCTS-COMPIOPAGG s 2,000,000 <br /> PRO- <br /> OTHER $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accidenl) $ <br /> AUTOS AUTOS <br /> HIREOAUTOS NON-OWNED PROPERTY DAMAGE $ <br /> AUTOS Per aoc7derit <br /> $ <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE s <br /> E%CESS LIAR HCLAIMS-MADE AGGREGATE s <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATSON PER OTH- <br /> AND EMPLOYERS'LIABILITY YIN STATUTE ER . <br /> ANYPROPRiETORIPARTHERIEXECUTIVE E.L.EACH ACCIDENT $ <br /> 0FF ICE RIMEMBEREXCLUOF0? NIA <br /> (Mandatary In NH) E.L.DISEASE-EA EMPLOYE $ <br /> ITye s,describe under -- — <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES{ACORD 101,Additional Remarks Schedule,may be 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 /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Orange County <br /> AUTHORIZED REPRESENTATIVE <br /> PO Box 8181 Jean M Droese <br /> Hillsborough NC 27278 <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br />