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Date <br />HOLDER CODE <br />INSURED'S NAME <br />PAGENOTEPAD: <br />Certificate holder is automatically included as additional insured for <br />General Liability, according to the terms, conditions & exclusions within <br />the policy with respects to work performed by the insured on behalf of the <br />certificate holder as required by written contract signed by an authorized <br />representative of the named insured and the certificate holder <br />ORACOUN 2 <br />Bar Roofing & Maintenance LLC 10/28/2020 <br />BARRO-2 <br />OP ID: CS <br />DocuSign Envelope ID: 0EF7DD70-27CA-4E40-8E88-1E6140CEC524