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DocuSign Envelope ID: D7239893-AF36-4784-B5F7-92811A2DB4CD <br /> DATE(MM/DD/YYYY) <br /> ACOR" CERTIFICATE OF LIABILITY INSURANCE <br /> 12/28/2015 <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(ies) 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 lieu of such endorsement(s). <br /> PRODUCER CONTACT Barbara Hoover <br /> NAME: <br /> Lester Ins. Group, Inc. T/A The Harper Agency ACNE Ext: (336)227-4271 FAX No: (336)222-9467 <br /> 1037 S. Main St. ADDRESS:barby.hoover @harperinsurance.com <br /> PO BOX 1867 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Burlington NC 27216 INSURERA:Erie Insurance Exchange 26271 <br /> INSURED INSURER B: <br /> Nice and Green Commercial Floor Care Services, DBA: INSURER C: <br /> 1940 Crawford Road Lot 27 INSURER D: <br /> INSURER E: <br /> Graham NC 27253 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:CL15122806487 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 /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> DAMAGE A CLAIMS-MADE � OCCUR PREM SESOEa occurrence)l $ 1,000,000 <br /> Q25-3121009 1/31/2015 1/31/2016 MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> X POLICY❑ PRO ❑ LOC PRODUCTS-COMP/OPAGG $ 2,000,000 <br /> JECT <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> Ea accident <br /> ANY AUTO BODILY INJURY(Per person) $ 100,000 <br /> A ALL OWNED SCHEDULED <br /> AUTOS AUTOS Q10-0630737 10/6/2015 10/6/2016 BODILY INJURY(Per accident) $ 300,000 <br /> NON-OWNED PROPERTY DAMAGE $ 100,000 <br /> HIRED AUTOS AUTOS Per accident <br /> Underinsured motorist BI split $ 100,000 <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N STATUTE ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? ❑ N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Attn: Tammy Comar ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box 8181 <br /> Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE <br /> Harper, Steven/JSN <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br /> INS025 rgmnm i <br />