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073 CERTIFICATE OF INSURANCECompany Name: National Fire And Marine Insurance Company <br />3024 Hamay. Street•Omahk Nebraska 68131-3580 <br />6This Certificate? of insurance is. NOT an Insurance policy and does not amend, extend or alter the coverage afforded by the policies listed hersis. <br />Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or may pertain; <br />the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies which may substantially limit <br />coverage. Where reference is made to an Aggregate Limit, those limits are Company's maximum liability under the Policy for the entire policy period <br />regardless of the number of insureds, Claimants or occurrences. <br />Date: 7/25/16 <br />NAME -OF INSURED: Hal _P Artificier Inc- <br />P.O. <br />ncP.O. ADDRESS: 545 New Bowers Road, Lexington, NC 27292 <br />POLICY NUMBER KINDS OF INSURANCE LIMITS <br />EFFECTIVE EXPIRES <br />72LPS025629 <br />COMMERCIAL GENERAL LIABILITY <br />4/28/2016 4/28/2017 <br />® Occurrence Form ❑ Claims—Made Form <br />Coverages <br />® Premises -Operations <br />® Products/Completed Operations <br />❑ Other (Specify) <br />General Aggregate Limit $2,000,000 <br />Products -Completed Operations Aggregate Limit $2,000,000 <br />Personal & Advertising Injury Limit $1,000,000 <br />Each Occurrence Limit $2,000,000 <br />Damage to Premises Rented $100,000 <br />Medical Expense Limit (Any One Person) 85,000 <br />A r ate Lirhdon Claims Expenses $ <br />AUTOMOBILE LIABILITY <br />Body Mj" Each Person S <br />Each Accident $ <br />Property Damage Each Accident $ <br />Bodily Injury and Property Damage Combined Single Limit $ <br />GARAGE LIABILITY <br />Bodily Injury and Property Damage Auto Only Other than Auto <br />Combined Singlle Lfmft S $ <br />Aggregate Limit $ <br />Geragekeepers Insurance ❑ Legal Liability $ <br />❑ Direct Access S <br />❑ Direct Prima $ <br />EXCESS LIABILITY <br />❑ Automobile ❑ General Liability <br />Name of Primary Insurer <br />Primary Limits $ <br />Excess Limits 'S <br />,General Aggregate Limit $ <br />Aggregate Limit)ncJusive of Claims eases <br />Workers Compensation $Statutory Limits <br />Employees Liability $ <br />Other <br />ur-091mir l IVDi Vr VrCPW l tuna: ror pyrumululau uluptax Yll Gfdw"Q C[ \w U 1u. rwlu Ya W. 1 Vw Iv. "Yu ,7wuW I au lgaYRw11a1 wwYlcu <br />on, the above, General Liability Policy with respect to fireworks display on date(s) noted above. "Policy indudes Company specific nnn-standard <br />endorsements which may be restrictive or exclusionary in nature." <br />In the event of any material change in orcancellation of said policies, the COMPANY intends to, but is not obligated toi notify the party to whom this <br />Certificate is addressed of such change or cancellation, and COMPANY undertakes no responsibility by reason of any failure to do so. <br />This Certificate Issued to: <br />City of Sanford, NC <br />P.O. Box 3729 <br />'Sanford, NC 27331-3729 <br />By: rpouglasI. Sanders <br />Title: President <br />M -100j (4191) NOTE TO AGENT— Mail Copy to Home Office Immediately <br />