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DocuSign Envelope ID: 38AF1350-3B2C-4641-8BA3-94F55EAC7592 <br /> 0 DATE(MM/DDIYYYYI <br /> AC R" CERTIFICATE OF LIABILITY INSURANCE <br /> 01/14/2016 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the <br /> certificate holder in liou of such endorsomont(s). <br /> PRODUCER NAME: T Joshua E Matthews <br /> Joshua E.Matthews Insurance Agency Inc. Pa c°NEE . (919)598-6800 ac No <br /> 2144 Page Rd.Suite 106 a RIE <br /> D <br /> Dss: Joshua @jmatthewsinsurance.com <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> Durham NC 27703 INSURERA: ERIE INS EXCH 26271 <br /> INSURED INSURER B: <br /> CAROLINA EARTHSCAPES INC INSURERC: <br /> 1841 N Nc Highway 119 INSURERD: _,,_. <br /> INSURERE: <br /> Mebane NC 27302-9364 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> TN­SR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR I D O POLICY NUMBER MMIDD/YYYY MWDDfYYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 RNTED <br /> CLAIMS-MADE �OCCUR PREMISES Eaoccurrrertce $ 1,00,000 <br /> MED EXP(Any one person) $ 5,000 <br /> A Q28-1121458 04/11/2016 04/1112016 PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> �{ POLICY M JECOT []LOC PRODUCTS-COMPIOPAGO $ 2,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea acedenl <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED 130DILY INJURY(Per accident) $ <br /> AUTOS NON-OWNED PROPERTY DAMAGE $ <br /> HIREOAUTOS AUTOS Peraccident <br /> S <br /> UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ _ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE S <br /> DEO I I RETENTIONS $ <br /> WORKERS COMPENSATION <br /> AND EMPLOYERS'LIABILITY X STATUTE Eft <br /> ANY PROPRIETORIPARTNER/EXECUTIVE YIN E.L.EACH ACCIDENT $ 100,000 <br /> A OFRCERIMEMBER EXCLUDED? �Y__. N/A Q96-2200425 12/22/2015 12122/2016 <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 <br /> if yas,descr be under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 <br /> DESCRIPTION OF OPERATIONS t LOCATIONS i VEHICLES(ACORD lot,Additional Remarks Schedule,may be attached if more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE A130VE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County DEAPR ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> AUTHORIZED REPRESENTATIVE <br /> Hillsborough NC 27278 <br /> ©'1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 26(2014/01) The ACORD name and logo are registered marks of ACORD <br />