2016-220-E AMS - Triangle Landscaping, Inc. for 129 E. King St. drainage improvements

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DocuSign Envelope ID: 72076813C-558E-4137A-A1 EB-350FEF87C8A4 OP ID: DR CERTIFICATE OF LIABILITY INSURANCE D04/18120Y6 04/18/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Phone:919-682-4814 NAME; Christine Barnett The Sorgi Insurance Agency Fax:919-682-4906 PHONE 919-682 4814 FAx 919-682-4906 16 Consultant Place Suite 102 vc No Ext• A/C No Durham,NC 27707 E-MAIL chris@sorgiinsurance.com James E.Sorg!,CIC PRODUCER CUSTOMER ID#:TRIALAN INSURER(S)AFFORDING COVERAGE NAIC# INSURED Triangle Landscaping Inc. INSURER A:Erie Insurance Exchange 26271 Brad Lewis dba 3582 Fletchers Way INSURER B: Stem,INC 27581 INSURERC: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUB POLICY EFF POLICY EXP LIMITS LTR POLICYNUMBER MM/DD MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 X COMMERCIAL TO RENTED GENERAL LIABILITY Q2726204479 0312612016 03/26/2017 PREMISES Ea occurrence $ CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: -PRODUCTS-COMP/OP PGG $ 2,000,00 POLICY PRO-LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea acc(denq $ 750,00 A ANY AUTO Q032630379 03/2612016 03/2612017 BODILY INJURY(Per person) $ ALLOWNEDAUTOS BODILY INJURY(Per accident) $ X SCHEDULEDAUTOS PROPERTY HIREDAUTOS (Perracdd nt)AMAGE $ NON-OWNEDAUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X I WCSTATU- OTH- AND EMPLOYERS'LIABILITY O L Y/N ER X ANY PROPRIETOR/PARTNER/EXECUTIVE Q872600559 03/26/2016 03/26/2017 E.L.EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,00 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 A Contractor's equip Q272620479 03/26/2015 03/2612017 Equipment 122,87 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Oran a COUn THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN g tY ACCORDANCE WITH THE POLICY PROVISIONS. PO Box8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE H j, j -- ' i u I ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD