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DocuSign Envelope ID:29100922-5A5F-4BOC-A438-4BBECA4F8A6A <br /> 4�ww DATE ) <br /> CERTIFICATE F LIABILITY INSURANCEF��02("IM27320 <br /> T CATIr IS ISSUED AS A MATTER OF INFORMAT''ON ONLY AND CONFERS NO RIGHTS UPON THE CF-"FICATE HOLDER. THIS <br /> C5-RTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AWKI), F)CrENO OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW- THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT 8ETW;;ZN THE ISSUING INSURF-R(S}. AUTHORtZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate§holder i%are ADDITIONAL INSURED,the policy;Ios}must be endorsed. If sUBROGATtON IS WAFVE13,subject to the <br /> terms and conditions of the policy, 01hlaln policies may require an endorsenbant. A stwerTlent on this certificate doas not confer rights to the <br /> cartlflcate holder in Yieu of�urh ertdorscmerd(,!�), <br /> =reTac-r <br /> Doug Wingate, Agent NAR1E;_ i�lelanieAllen+ <br /> 414 WydiFf Rd, Ste 110 pin <br /> pRpp�iGEk mo t��t�37$70868 i+!�f+�1- <br /> EiAAIL <br /> Raleigh, N 7607 AD SS,mel8r�le.SJ311en-1123a st&Ilef Ym_aam <br /> III-SURER(SY AFFQIa34NG CMERACE _#W_C <br /> N!SUFW;R A:State Faun Fire and Cssualtw Company . _ zs 4s-- <br /> „`GUREW Magner, Bradley DBA OddFellaws NISURi R B Sk�1L9 aryr,fduwaY Au6onuohil�lrlauYarw -4Qmr - 26178 <br /> to aAeting and Design - <br /> 19 W Hargett St Ste 310 7r}$WrR o:'"S' E -- <br /> RalAgh� Nr, 27601-13 1 -- <br /> Ih3LIdIER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER'. <br /> TF118 1S 1'O CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED)J0 THE INSURED NAMED ABOVE. FOR THE POLICY PERIOD <br /> INDICATED- NOTWITHSTANDING ANY REOUIREIVIENT. TERM OR CONID1710t'l OF ANY GONITRACT OR OTHER DOCUMENT M11-11 RESPECT TO V41-I1CH THIS <br /> _ CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, 7NE INSURANCE AFFORD BY THE POLICIES DF-8M13F_O HEREIN 1S SUBJECT TO ALL THE TERMS, <br /> EXCLU91L]N9 AND CONDITIONS OF SUCH POLICIES,I,IMLT$SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIM$. -- <br /> IIISR TYPE OF1N5WANC€ vDUOR putiCYNki pOLiC.�fEFF MIREMI Lilrr5 <br /> LTR S <br /> GENEUAL uPANUTY y y 83-90-0876-4 0712712019 1)7127 D20 EACH OGrWFZENr;C # 1,04L3 OL70 <br /> -UWAIW 7O Ff N1tI5—- <br /> DoPA&A6+4cml GF.HFRAL LLrS krfY PREMI=ESIEe,-„ .. �+? _# 300,000 <br /> CLAIMS-MACE i " 100PJR MED E P UAryF om pg?m? 5 .- <br /> Primarr 11Vr1 GOn![ibuL4f+- PERSOraai.A wv INJUR F s S,OQO,OPl7 <br /> ��NFRf�l�GGR,EGRTE S 2,OOi15,044 <br /> GEN'L PtiGREGATE LIMFF APPLIES PER. PRCML1C YS•COMFILW AOG .S 2,D.`1P,C00 <br /> POLICY Pr?. 1-1 LOC # <br /> AUTOMOBILE LYSBIU" E 2 SINGLE L119T <br /> Ariv Alm QODILY INJURY P'eff pa 5 � <br /> AUT06 ALLOWNEIn I SCTOSULED BODILY INJURY(E`er ELGIWM9 - - <br /> NON-n M4 PROPERTY DAMAGE S <br /> _ HIKEU Alr= ALrfG6 FI*rw000 - - --- <br /> ;5 <br /> 1 UMBRELLA L" C7CCUR tACH OCLUKNENCE ;5 . <br /> . -- P QUS!3 LLALH _ GLrarzG-mALE I? RELATE <br /> I OED I PETEITRON5 <br /> I WWKERS COMPENSATION 4OR37,4TU- OTH- <br /> AIW EMPLCW6FkS'41AaarT'F <br /> ANY PROPRIETOWARTNMEXECUTWE *I NI N r* E.L.EACKA000F7%T I$ <br /> GE(*Fi 'F,eLMMR EXCLUDED? I <br /> 4KaMatory ii NNI 11 E.L_DISEASE-CA EMf'LQ 5 -. . <br /> - <br /> TI"s.anscko under <br /> r I=.1. OlsxAcr.•POLICY LIMIT 5 <br /> I UL'�cfd�TION OF OPERATIONS a LOCATIONS a VFHIGLES {Meech*CORD lot.AddtioMl RemMa Scr+adnleL.Ir morn spore Is raquimd) <br /> P <br /> CERTIFICATE HOLDER CANCELLATION <br /> Chapel HiIlfDran County VlSktprg Bureau SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEV BEFORE <br /> TKE: EXPIRATION DATE THEREOF. NCr7TCE WILL HE DELIVEREU Ill <br /> 5101 W Fran kHrLSt ACCORUANCIEWITH THE POLICY PROVISIONS. <br /> Chapel Hill, NC 2751E <br /> auTr�oamLh li€PAESPxrA <br /> &+1 -2010 AedRo CORPORATION L All rights reserved. <br /> ACORD 25(2010205) The ACORD name and logo are registet'ed marks of ACORD 1001486 132849.E 1 1-1 5-201 0 <br />