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DocuSign Envelope ID: 563913F3-CO1E-4251-A6B8-2547F725F6F2 <br /> r <br /> CERTIFICATE OF INSURANCE <br /> Erie THIJS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION ONLY <br /> lnsuran cI 6 <br /> F i✓3S,r 3126 NA—ntllslsurar,CA <br /> ---AGN�Tq ic. <br /> MIT <br /> NAME AND ADDRESS 6F ACIFNC' i�T1TFF0',)T&- Y01LING INS GR"") I,"' F-YSGASUA01C PANY <br /> 1]1576 <br /> 616 N IS i'AV V E It <br /> Re NY <br /> his cerffbilical <br /> (1);9)2 1 <br /> 7 .......... no 1i his all tivtly or <br /> 11 Tely Ame aTd,extend,or otherhise altr^r Che terms, Xclusions <br /> as condifions of insurance colreraQjo conlained In Me policY(ifs) <br /> Axis Con$11-llcliffll Man�lgcrflcllt <br /> Indicated below.The terms ands conditions of the liOlicy(jes)govern <br /> the Insurance given coverage as applied lo any ggiven situation,Limits <br /> INC shown may have been reduced by rIalms paid.this certificate Of <br /> t)ulhaln CI apeI Hill insurance does not constitute, a 4,aplTact between the issuing <br /> insu,rer(s), authorized repTesellialivt or producer and The <br /> 1),ii-hain, NC 27707 certificate holder. <br /> al tae 0 0 jS t)-117 <br /> as ndiiiied T -he Poky NuMbE �1 0AFS <br /> TKK,OFJNS AKi pa�icy NUMK"R, <br /> EACH OCCURRENCE <br /> 1 P <br /> GENERAL LIABILITY 1 1 TI <br /> I Q 3 5 0 12 2 Qb' FIRE D MAGE CA, fve <br /> �X COMMERCIALGENERALLIABILITY1 <br /> EMEIYE,xPIAny'lnrtarsm °. <br /> CLAW Wbt PERSONAL A AUVIOINJURYI:$ <br /> ATt <br /> 2 <br /> 301 AGGREW1 LIMP APPLIES PER: <br /> Pouch Pqwt�L_L] _---­ ­----- '.— <br /> BODILY INJURY <br /> AUTOMOBILE LIABILITY If AGN PERSON) i <br /> iOWNE0 HIRED, <br /> "AWAb"" NON-044NED) <br /> OWNED <br /> PROPERTY DAMAGE <br /> HsAED B 00 ILY INJURY ACID <br /> NON-OWNED ppOPECOMBINED PTYDAMAGE <br /> GARAGE <br /> $ <br /> XCIESS LIABILITY A(4 E AT <br /> R E <br /> ocnERRENcE <br /> $ <br /> RETENTION S <br /> ACCICIENT S 11 (N()(),()00 EACH <br /> ACCIDENT <br /> Q05 01,02�49 BODILY <br /> EMPLOYERS LIABILITY NJURY WSEAS1 S <br /> B( <br /> By 0GEA E S A I)00,(100$,.GTH�FMP)Offl: <br /> OTHER <br /> w RTES ADDFD By fK <br /> T)-ffLRIPTION OF UP <br /> WILL BE I)ELIV- <br /> CANCELLATION: SHOULD ANY OF THE A30VE DESCRIBED POLICIES BE CANCK.LED BEFORE THE EXpIRAT 01 DATE I H E4 EDF,N011CF <br /> EKED IN,ACCORDANCE WITH THE POLICY PROVISIONS, <br /> IJiPORTANJ, <br /> t the CeW <br /> ItiCate holder is an ADDITIONAL INSURED,the policy(iieS) Inust be endorsed.q SUBROGtXIC A IS WAIVEJ),subject t)the <br /> terms and Conditions of the policy,Certain pftjeS may require ali endorsel-nent.A,ilijtement rin bi!;cerfificate does not canter <br /> rights to the Certificate holder In lieu of suet endC)rselnent(S). <br /> NAME AND ADDRESS Chi CERTIFICATE HOLDER <br /> 3ox <br /> Nl( 272'7�I <br /> Page I o� <br /> C (3F,210 <br />