2014-612-E AMS - Triangle Landscaping Inc. for Parking Lot repairs $4,100

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DocuSign Envelope ID:2C1 FDF84-297F-4DF6-9639-6411484C13FC OP ID: DC AFRO° CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDlYl''1) osr22r2o1 a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone:919-6824814 CO TAC The Sorg! Insurance Agency PHONE Debbie Callahan FAX 16 Consultant Place Suite 102 Fax:919-682-4906 c No Ext:919-682-4814 (A1C No): 919-6824906 Durham, NC 27707 E-MAIL s:debbie@sorglinsurance.com James E.Sorg/,CIC PRODUCER cUSTOMERID a:TRIALAN INSURER(S)AFFORDING COVERAGE NAIC INSURED Triangle Landscaping Inc. INSURERA:Erie Insurance Exchange 26271 Brad Lewis dba INSURERS: 3582 Fletchers Way Stem, NC 27581 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.INSR AUUL WIT TYPEOFINSURANCE D NEFF EXP LR POLICYNUMBER MM1DD POLICY 1D LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY Q2726204479 03/26/2014 03/26/2015 PREMISES Ea occurrence $ CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE .$ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,00 POLICY PRa LOG $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT A ANY AUTO Q032630379 03/26/2014 03/26/2015 (Ea accident) $ 750,000 BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS e PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ $ UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- 11 AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER X ANY PROPRIETORIPARTNERIEXECUTIVE Q872600559 03/26/2014 03/26/2015 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-FA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION)OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 500,000 A Contractor's equip Q272620479 03/26/2014 03126/2015 Equipment 92,300 DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required) CERTIFICATE HOLDER CANCELLATION l SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 a County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Oran g ty ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD