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Erie CERTIFICATE OF INSURANCE DATE ISSUED(MM/DDNY) <br /> Insurance° —THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY— 4/22/14 <br /> Home Office • 100 Erie Insurance Place - Erie,Pennsylvania 15530 • 814.870.2000 <br /> Toll free 1.800.458.0811 • Fax 814.870.3126 • www.eriefnsurance.com <br /> NAMEANDADDRESS OFAGENCY THE BALLARD AGENCY INC AGENTS N0. <br /> 105 W KING ST JJ I O l 0 -90-:-C DAER� CEEE�ppH(( &CAST!_ �Y COMt _ <br /> HILLSBOROUGH,NC 27278-2543 -C� ErIa Indemn iNCCo.�Attome-in-Fact oRtApp ca e <br /> (919)732-2158 This certificate Is issued for information purposes only and confers <br /> NAME AND ADDRESS OF NAMED INSURED no rights an the certificate holder.It does not afifrmativefy or <br /> negatively amend,extend,or otherwise after the terms,exclusions <br /> HISTORIC HILLSBOROUGH and conditions of insurance coverage contained In the poticyges) <br /> COMMISSION Indicated below,The terms and conditions of the pDllcy(ies)govern <br /> the Insurance coverage as applied to any given situation.Limits <br /> PO BOX 922 shown may have been reduced by claims paid,This certificate of <br /> HILLSBOROUGH,NC 27278 insurance does not constitute a contract between the issuing <br /> insurers), authorized representative or producer and the <br /> certifica a holder. <br /> This Is to certify that oollcias,as Indicated bytha Policy Number below,are In farce for the Named Insured at the time that the Certificates being Issued. <br /> 5• . 10., C 0 MB LIMITS <br /> E®GENERAL LIABILITY "EAGH'dCCURRENct 1,000,000 <br /> ®COMMERCIAL GENERALLIABILiTY Q33 1700764 9/17/14 9/17/15 <br /> FIRE DAMAGE Wy One Fire 1,000,000 _ <br /> ❑CLAIMS MADE ®OCCUEj ME EXP Rny One Person 5,000 <br /> ❑ PERSONAL&Aft INJURY 1,000,000 <br /> (� GENERAL AGGREGATE 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PERJ I PRODUCTS=COMP/0AGG s 2,000,000 <br /> ®POLICY ❑PROJECT ❑LOCI <br /> I❑❑ AUOMOB ILE LABILTY I BODYNUR <br /> OE)' A PERSON <br /> $"ANYAUTO" N OND <br /> ❑ <br /> E <br /> OWNED ACHIY IAWNDURY S <br /> ❑HIRED PROPERTYDAMAGE- :S <br /> ❑NON-OWNED I BODILYiNJURYANlY <br /> PROPERTYDAMAGE $ <br /> ❑GARAGE I COMBINED,-.. <br /> ❑EXCESS LIABILITY EACH OCCURRENCE S <br /> ❑OCCURRENCE " .4d(IREGATE - <br /> s <br /> ❑RETENTION S S <br /> I <br /> E WORKERS COMPENSATION& 86 0600392 1 2/2/14 2/2/15 <br /> EMPLOYERS LIABILITY BODILY <br /> BODILY ACCIDENT S 100,000 EACH ACCIDENT <br /> NJURY DISEASE S 500,000 POLICYuMR <br /> j j I BY DISEASE S 100,000 EACH EMPLOYEE <br /> OTHER <br /> I <br /> I <br /> I I <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHiCLES/EXCLUSIDNS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIV- <br /> ERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.if SUBROGATION IS WAIVED,subject to the <br /> terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer <br /> rights to the certificate holder in lieu of such endorsement(s). <br /> NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> ORANGE COUNTY HUMAN SEVICES AGENCY AMORREDREPRESMATNE <br /> PO BOX 8181 <br /> HILLSBOROUGH,NC 27278 _ <br /> EIG6230 8111 <br /> Page 1 of t <br />