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DocuSign Envelope ID:OD587B88-8922-4OFB-BEO6-A667C1 1 D58E7 <br /> Erie CERTIFICATE OF INSURANCE DATEISS2UED(MM/DONY) <br /> nsurance /23/14 <br /> --THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY--- <br /> Home Office • 100 Erie Insurance Place o Erie. Pennsylvania 16530 • 814,870 2000 <br /> Toll free 1 800 458,0811 • Fax 814,870 3126 • www erieinsurance com <br /> NAME AND ADDRESS OF AGENCY BAREFOOT& YOUNG INS GROUP LLC AGENT'S NO LRpf� AAOR lz_L.UVLI'�GE .. <br /> d . I <br /> 616 N 1ST AVE JJ1524 Co.: E ERIE Indemnity INSURANCE AtHANGE n Fact(N (���YivY <br /> KNIGHTDALE, NC 27545-8506 y Not A Applicable <br /> , i�,IA.CL COQ YF YORK <br /> (919)217-5870 p ly and confers <br /> ®... ......—. - - . This certificate is issued far information purposes o <br /> NAME AND ADD no 1 on the certificate holdorw lit does not. affirmatively or <br /> RESS OF NAMED INSURED i <br /> no at vel amend,extend,or otherwise alter the terms,exclusions <br /> Axis Construction Management and conditions of insurance coverage contained in the policy(les) <br /> 3308 Durham Chapel Hill BLVD indicated below.I he terms and conditions of the policy(ies),govern <br /> the insurance coverage as applied to any given situation.Limits <br /> Sutie 150 shown may have been reduced by claims paid.This certificate of <br /> insurance does not constitute a contract between the issuing <br /> Durham,NC 27707 insurer(s), authorized representative or producer and the <br /> certificate holder. <br /> r the Named Insured at the time that the Certificate is being Issued,, <br /> This sl to Uer11 TYPE, F INa11RAh-0CE Indicated thn.Poky are In force for <br /> S <br /> a _ CY <br /> 1 GENERA L LIABILITY EACH OCCURRENCE 1,000,000 <br /> MMERCIAtGLNERAI LIABILITY Q35 0122062 11/1/14 11/l/l5 (Any � e $ <br /> CO FIRE DAMAGE An Oni LAPS 1,000,000", <br /> f „I MAIMS MADE L _I OCCUR MED EXP(Any One I'eison) $ 5,00 <br /> ......... &ADV.INJURY 1,000000 <br /> PERSONAL .a�_�� ._.... <br /> ❑ GENERAL AGGREGATE S - 2,000,000 <br /> GENT AGGREGATE LIMITAPPLIES PER PRODUCTS-COMP/OP AGG$ 2,000,000 <br /> ❑POLCY [N]PROJECT ❑LOC <br /> AUTOMOBILE LIABILITY BODILY INJURY <br /> "ANY AUTO"(NON OWNED) (EACH PERSON) $ <br /> .0 OWNED BODILY INJURY <br /> EAC( ACCIDENT I.. .$. <br /> HIRED PROPERTY DAMAGE $ <br /> BODILY I� NON-OWNED J <br /> �❑ GARAGE PROPERTY COMBINED AGE $ <br /> I <br /> EXCESS LIABILITY EACH OCCURRENCE <br /> C� OCCURRENCE . <br /> AGGREGATE _.,m.....$..,...,....... <br /> RETENTION $ $ <br /> EMPLOYERS LIABILITY Q95 0102849 1 1/1/14 1 1/1/15 <br /> f WORKERS COMPENSATION& <br /> BODILY ACCIDENT $ 1,000,000 EACH ACCIDENT <br /> INJURY DISEASE $ 1,000,000 POLICY LIMIT <br /> ry <br /> BY DISEASE $ 1,000,000 EACH EMPLOYEE <br /> OTHER <br /> I <br /> DESCRIPTION OF OPERATIONS/LOCA:fIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED B <br /> EFORE 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 Government AUT'JOI'I17H)REPRESENTATIVE <br /> PO Box 8181 <br /> Hillsborough,NC 27278 <br /> g <br /> Li6�G�a��i t W <br />