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NORTH CAROLINA JOINT UNDERWRITING ASSOCIATION <br />PO Box 8009 - Cary, NC 27512 <br />(919) 821-1299 - www.ncjua-nciua.org <br />DECLARATIONS PAGE <br />DWELLING PROPERTY 2 <br />BROAD FORM <br />NAMED INSURED/MAILING ADDRESS PRODUCER <br />Barbara Young <br />301 Helmsdale Dr <br />Chapel Hill, NC 27517-6540 <br />Producer Code: 671363 <br />Robbie Norris <br />NC Farm Bureau <br />102 S Estes Dr <br />Chapel Hill, NC 27514-2880 <br />(919) 960-6801 <br />Policy DW00707347-01 <br /> New <br /> Renewal <br /> Rewrite Policy Bill To:Insured <br /> Amended Date:Installments:Full Pay Automated <br />Processed Date: 10/20/2023 INSURED <br />DCL 10 17 1 of 2 <br />POLICY PERIOD:Effective Date: <br />10/20/2023 <br />Expiration Date: <br />10/20/2024 <br />Total Policy Premium: $792.00 <br />The terms of this policy shall begin at 12:01 AM Eastern Standard Time at the address(es) shown below. <br />We will provide the insurance described in this policy in return for the premium and compliance with all applicable policy <br />provisions. Coverage is provided where a premium or limit of liability is shown for the coverages. <br />The described location(s) covered by this policy: <br />1.144 Weaver Dairy Rd Chapel Hill NC 27514-6827 <br />Rating Info: <br />Location <br />Number <br />Family Units Occupied By Protection <br />Class <br />Year Built Territory Code Construction <br />Type <br />1 1 Owner Non- <br />Occupied <br />02 1957 280 Frame <br />DEDUCTIBLES In case of loss we cover only that part of the loss over the deductible stated below: <br />All Perils $2,500 <br />DocuSign Envelope ID: 37E6FC08-EFB2-4BED-84D4-D670E87CC3BC