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DocuSign Envelope ID: B9A906B0-9DD2-4524-9A82-04C276B8A99E <br />OP10:LH <br />DATE(MMIDOIYYYY) <br />CERTIFICATEOFLIABILITYINSURANCE <br />0511512015 <br />THISCERTIFICATEISISSUEDASAMAnEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTIFICATEHOLDERTHIS <br />CERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIES <br />BELOW.THISCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZED <br />REPRESENTATIVEORPRODUCER,ANDTHECERTIFICATEHOLDER. <br />IMPORTANT:IfthecertificateholderisanADDITIONALINSURED,thepolicy(ies)mustbeendorsed.IfSUBROGATIONISWAIVED,subjectto <br />thetennsandconditionsofthepolicy,certainpoliciesmayrequireanendorsement.Astatementonthiscertificatedoesnotconferrightstothe <br />certificateholderInlieuofsuchendorsement(s). <br />919-682-4814 <br />Phone: <br />PRODUCER <br />~;Jo <br />TheSorglInsuranceAgency <br />919-682-4906 <br />Fax: <br />919-682-4906 <br />919-682-4814 <br />No" <br />16ConsultantPlaceSuite102 <br />Ie@s,rgi" <br />Durham,NC27707 <br />JamesSorgl.CIC <br />INSURER/SIAFFORDINGCOVERAGENAie. <br />TriangleLandscapingInc. <br />INSURERA:ErieInsuranceEllchange <br />26271 <br />INSURED <br />BradLewisdba <br />INSURERS: <br />3582 <br />FletchersWay <br />INSURERC: <br />27581 <br />Stem,NC <br />INSURERD: <br />INSURERE: <br />INSURERF: <br />COVERAGESCERTIFICATENUMBER:REVISIONNUMBER: <br />THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIOD <br />INDICATED.NOTWITHSTANDINGANYREQUIREMENT.TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS <br />CERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS. <br />EXCLUSIONSANDCONDITIONSOFSUCHPOLICIES.LIMITSSHOWNMAYHAVEBEENREDUCEDBYPAIDCLAIMS. <br />POLlCYEXP <br />,~Ol.tCYEFF <br />II~~I <br />TYPEOFINSURANCELIMITS <br />POliCYNUMBER <br />MM <br />1,000,OOC <br />~NERAlLIABILITY <br />EACHOO::URRENCE <br />03/26/201503/26/2016 <br />02726204479 <br />COMMERCIALGENERAL.LIABilITY <br />PREMISESEa~~ncel <br />CLAIMS-MADEOCCLRMEDEXP{Anymeperson} <br />l,OOO,OOC <br />PERSONAlADVINJURY <br />2,OOO,OOC <br />GENERALAGGREGATE <br />2,OOO,OOC <br />PRODUCTS.COMPiOPIGG <br />~'~AGG~n;L1MITAPnSPER' <br />POliCYlOC <br />COMBINEDSINGLELIMIT <br />AUTOMOBilELIABILITY <br />750,OOC <br />(Eaaccident) <br />03/26/201503/26/Z016 <br />0032630379 <br />AtffAUTO <br />BODilYINJURY(Perperson) <br />AllOWNEDAUTOS <br />BODilYINJURY(Peracadent) <br />SCHEDULEDAUTOS <br />PROPERTYDAMAGE <br />(Peracaclent) <br />HIREDAUTOS <br />NON.QWNEDAUTOS <br />UMBREllAL1AB <br />EACH<>a:URRENCE <br />H~UR <br />EXCESSUAB <br />CLAlM$-MADEAGGREGATE <br />DEDUCTIBLE <br />RETENnON <br />WORKERSCOMPENSAnONI.WCSTATU-~I <br />IOJt'. <br />ANDEMPlOYERS'UABIUTY <br />100,00 <br />1087Z600559 <br />03/26/201503/26/2016 <br />ANYPROPRIETORJPARTNERlEXECUT1VE <br />EL.EACHACCOENT <br />OFFICERIMEMBEREXCLUDED? <br />100,00 <br />(MandatoryInNH) <br />EL.DISEASE.EAEMPLOYE <br />500,00 <br />'t,r;?OPERATIONSbei()NELDISEASE.POLICYLIMIT <br />Q272620479 03/26/201592,30 <br />AIcontractor'sequip <br />03/26/20161EQUiPment <br />DESCRIPnONOFOPERAnONSILOCAnONSVEHICLESjAttachACORD101.AdditionalRemar1o:sSchedule.itmorespaceisrequired) <br />OrangeCountyisanadditional~nsuredasrespectsgeneralliabilityarising <br />fromtheinsured'soperations,asrequiredbywrittencontract,perform <br />CANCELLATION <br />CERTIFICATEHOLDER <br />SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORE <br />THEEXPIRATIONDATETHEREOF.NOTICEWILLBEDELIVEREDIN <br />OrangeCounty <br />ACCORDANCEWITHTHEPOLICYPROVISIONS. <br />PO <br />Box8181 <br />27278 <br />Hillsborough,NC <br />AUTHORIZEDREPRESENTAnVE <br />1988-2009 <br />ACORDCORPORATION.Allrightsreserved. <br />25(2009/09) <br />ACORDTheACORDnameandlogoareregisteredmarksofACORD <br /> <br />