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DATE (MM/DD/YYYY) <br />AGENCY PHONE <br />(A/C, No, Ext): <br />COMPANY <br />E-MAIL <br />ADDRESS: <br />FAX <br />(A/C, No): <br />CODE:SUB CODE: <br />AGENCY <br />CUSTOMER ID #: <br />INSURED LOAN NUMBER POLICY NUMBER <br />EFFECTIVE DATE EXPIRATION DATE <br />THIS REPLACES PRIOR EVIDENCE DATED: <br />LOCATION/DESCRIPTION <br />COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE <br />NAME AND ADDRESS <br />AUTHORIZED REPRESENTATIVE <br />CONTINUED UNTIL <br />TERMINATED IF CHECKED <br />ADDITIONAL INSURED LENDER'S LOSS PAYABLE <br />MORTGAGEE <br />LOAN # <br />LOSS PAYEE <br />THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE <br />ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE <br />COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE <br />ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />PROPERTY INFORMATION <br />COVERAGE INFORMATION <br />REMARKS (Including Special Conditions) <br />CANCELLATION <br />ADDITIONAL INTEREST <br />ACORD 27 (2016/03) 1 of © 1993-2015 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br />NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br />EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS <br />SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />PERILS INSURED BASIC BROAD SPECIAL <br />ACORDTM EVIDENCE OF PROPERTY INSURANCE <br />20CASA <br />09/28/2021 <br />McGriff Insurance Services <br />Post Office Box 13941 <br />Durham, NC 27709 <br />919 281-4500 <br />507553 <br />8887468761 tgroberts@mcgriff.com <br />Hanover Insurance Company <br />Box 85612 <br />Richmond, VA 23285 <br />Merritt Mill Apartments, LLC <br />PO Box 12545 <br />Raleigh, NC 27605-2545 <br />IH6H735467 <br />09/30/21 11/17/22 <br />Location #1 800 S. Merritt Mill Road <br />Chapel Hill, NC 27516 Building #1 24 Two BR Apartment Units <br />Location #1 800 S. Merritt Mill Road <br />Chapel Hill, NC 27516 Building #2 24 One BR Apartment Units/Community Center <br />BUILDERS RISK COVERAGE INFORMATION <br />Job Specific Completed Value: <br /> Loc.# Bldg.# <br /> 1 1 9,000,000 <br /> <br />****** Supplemental Names ****** <br /> <br />Type: Insured Multiple Names <br />Merritt Mill Apartments, LLC <br />(See Attached Remarks) <br />Orange County <br />300 West Tryon Street <br />P.O. Box 8181 <br />Hillsborough, NC 27278 <br />2 S 1103207 <br />TGR <br />DocuSign Envelope ID: C902EFF9-56ED-450F-9212-1E71966C673A