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DocuSign Envelope ID:094C147D-86BF-4209-9925-2A2FCCACE30D <br /> CERTIFICATE HOLDER'S COPY <br /> I Erie CERTIFICATE OF INSURANCE DATE ISSUED(MM/WXYY) <br /> 4 Insurance® —THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY— 05/09/16 <br /> Home Office • 100 Erie Insurance Place • Erie,Pennsylvania 16530 • 814.870.2000 <br /> Toll free 1,800 458.0811 • Fax 814,870.3126 - vvwvv erieinsurance,com <br /> NAME AND ADDRESS OF AGENCY AGENT'S NO. <br /> 2ha4garMlaml Blvd Services, Inc. C O rRieLlnd mnit Co.RAtHAN u-In CAN Fact_ pl <br /> 01 S. I Co.:E pfEkCHAN6 Not A� icab e <br /> Durham, NC 27703 e x.F 1 S r 2n A Y. F NF YORK <br /> ._-_----- This certificate is Issued for information purposes oniy�and confers <br /> -NAME AND ADDRESS OF NAMED INSURED ne right's on the certificate holder. It does net aflirmn'ativaly Or <br /> Wilkerson Grading Co no ativel amend,extend,or otherwise alter the terms,exclusions <br /> Paul Leroy Wilkerson Jr DBA an conditions of insurance coverage contained in the policy loss <br /> Y indicated below„The terms and conditions of the polloy�1 a <br /> 318 Rabbit Lane -govern the Insurance coverage as applied to any raven <br /> Hillsborough, NC 27278 <br /> Ltald.This Limits shown may have been reduced by cairns <br /> certificate of insurance do es not consfitnle a.contract <br /> he issuing insurer(s), authorized representative or <br /> and the certificate hnldnr_ <br /> T Is is to certifv that oollcies as indicated by the Policy Number below,are in force for the Named y�Insured�yaIt the time that the Certificate is being issued. <br /> L� i�ddJi TYPE OF INSURANCE POLICY NUMBER y FF' l RAFYIeh'i1515'N ,. . LIIMITS <br /> 8 GENERAL LIABILITY EACH OCCURRENCE 1 x000 000 <br /> COMMERCIAL GENERAL LIABILITY Q32-2500511 08/25/15 08/25/16 FIRE DAMAGE(Any One Fire) .1 000,000 <br /> El CLAIMS MADE [0 OCCUR <br /> MEDExP Perso 5w000 <br /> `] ,, PERSONAL&ADII INJURY 1 n000Y00GW <br /> __. -------- GENERALAGGREGATE 2p000,000 <br /> 61ENTAGGREGATE I 000 <br /> POLICYDPROJECTPLI❑ESP : PRODUCTS-CO <br /> OEC nMP/ OPAGG 2000 m <br /> FJ AUTOMOBILE LIABILITY BODILYINJURY <br /> [] "ANYAUTO"(OWNED HIRED, (EACH PERSON) $ <br /> NON-OMED) BODILYINJURY <br /> ] OWNED —wr nru ArTAUNTL $............_..... <br /> �] HIRED PROPERTYDAMAGE $ <br /> []NON-OWNED BODILYINJURYAND <br /> PROPERTY DAMAGE <br /> GARAGE COMBINED <br /> f EXCESS LIABILITY _EArHnr_,ruRBFNrE_$_ <br /> �]OCCURRENCE <br /> _. ... AGGREGATE..... .......... .._- _._.,.. <br /> $ <br /> []RETENTION $ <br /> 6.' WORKERS COMPENSATION & Q92-2500289 08/25/15 08/25/16 STprn7a v <br /> EMPLOYERS LIABILITY BODILY ACCIDENT $ 100,000 EACH ACCIDENT <br /> INJURY DISEASE $ 500,000 POLICYLIMIT <br /> BY DISEASE $ 100,000 EACH EMPLOYEE <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> CANCELLATION: SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATETHEREOF,NOTICE WILL BE DELIV- <br /> ERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed, If SUBROGATION IS WAIVED,subject to the <br /> terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer <br /> rights to the certificate holder in lieu of such endorsement(s). <br /> NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> AUTTIORIdEID REPAESIENTATIVF <br /> Orange County <br /> PO Box 8181 <br /> Hillsborough, NC 27278 <br /> E.IG6230 8/1 I <br />