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DocuSign Envelope ID: lE463956-EA9F-49E5-80F3-FE5F52A5605F <br /> Erie CERTIFICATE OF INSURANCE <br /> WE MWED MWMYY¢ <br /> n s u r a n c THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION GINLY <br /> V! �Ff"? rsu-ance �Rc!E, E"lc �3�) '4„3 ;,,T,,�) <br /> NAME AND ADCHTSS OF AUNCY (, S AGFN I`$K. <br /> INSI'RANCE', <br /> J)10.11 CA Y' <br /> 025­203 11tJL1_%Rl)('01JRT �AL <br /> r r <br /> P,7,1�K.-Y� P <br /> f(A[FICILNC �7615-6801, r e Ride lin Cp,,,Aftort 0 Y <br /> 4NIP" <br /> c8Z <br /> This crillitallo is Issued br Information pulps s only and confers <br /> no ri his an The certlificate holder, it does not affirmatival or <br /> 4 vilvoly$mad,atood,or otbori vise Our the lotms,w1disfoos <br /> Advwwed Sealcoataio Inc 001 coaditions of Insutsoca covers a Contained In he polky(ivs) <br /> Indicated below,The terms and conditions of the pollcylies)govern <br /> XX(,'4 FrirM�rook DR the insurance coverage,as applied to any given si!tuaboin.Limits <br /> Rateigli. NC Y7647 shown may have been reduced by claims paid.This certificate of <br /> insurances does Dal eon hate a 0040304 114110044 tin ISSViAq <br /> lmsurZs), lotborited ropriossolative or producer and the <br /> Joertifical a holden. <br /> h1 s lG c f o Ct r ac q t C I MW FOR,rM Z lace Ei ft Wed kiW@ it the UM T01 148 IS,"J <br /> P 1 11M-I I IJ-mo Q]C <br /> _1724 7Y.7 57 LUIS <br /> E]GENERAL UARILITY Q�310 1320797 6,]31 61 16 EACH OCCME 1,000,0100 <br /> ,S)XkWFACAkGENEM1UA3lIJTY�: <br /> QLAi'SMADE MR, NED EXP ft Om Pr�r j <br /> KR50NAL&Aft INJURY <br /> GBERALAGGREGAIE <br /> 'Irfft COP AIG <br /> jfGAIE LIMITAPPUES 1$,R� PRODUCTS- MWO <br /> N Kuy [:1[MWEM EJ l4t" <br /> A11704408ILE UASJUTY eviNLYWOW <br /> "ANYAM`M 1 6 I)A 6 <br /> kdI <br /> 80M JURY <br /> GAArIkIA E", AIMMD <br /> MOK'MY MIME <br /> 80 MY IKM AND <br /> IR(PERTY 3AMMA <br /> Gwne F <br /> EXCESS LIA8110 EA04 OCCAMENCE <br /> 'Q ox�mha Q 30 1370 134 1.1',16 AGATE s <br /> REIFOON S 0 <br /> WORKERS COMPENSATION& <br /> EMPILOYEAS LIABILITY Q9() I_�wrq6 _,15 6 13''16 RIN ty A *N I 500,O(K)EAW=30EN7 <br /> �F <br /> INJU" <br /> By OMEASE ';0fi3O(X)EACH E rAPL(WEF <br /> OTHER <br /> O(SCA Ipt")k OF <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 POUCY PROVISIONS. <br /> IMPORTANT'. If the certificate holder is an ADDITIONAL INSURED,Die olio ties)must be en&rsed. If SUBROGATION IS WAIVED,subject to Me <br /> torras and cosirlitions oftlie policy,certain policies may require at endorsertient.A statentent(xi ffils cerfiticate does not rotifer <br /> rights to the cartif irate 111older in,heu of sucli Pridorsearetit(s). <br /> NAME Amb ADDRESS OF CERTIFICATE HOLDER <br /> oranu,e Cuutily RLNESTJdATT61 <br /> P0 Rox 8 I 8 1 <br /> I a)Ug,�_ N, C' 2 7.7 7,R <br /> &Gb230 W I1 Page I of I <br />