2016-540-E AMS - Triangle Landscaping, Inc. for Homestead Road Sidewalk

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DocuSign Envelope ID: 536C9702-1997-4E72-A2EA-3629ACE96C23 OP ID: DR AC RE) CERTIFICATE F LIABILITY INSURANCE DATE(MM/DD/YYYY) 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(ies) 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 Phone: 919-682-4814 NAMEACT Christine Barnett The Sorgi Insurance Agency 16 919-682-4906 PHONE xtl:919-682-4814 FAX 919-682-4906 16 Consultant Place Suite 102 IA/C,No,E (A/C,No): Durham,NC 27707 E-MAIL chrisnsor iinsurance.com ADDRESS:James E.Sorgi,CIC PRODUCER V g CUSTOMER ID a:TRIALAN INSURER(S)AFFORDING COVERAGE NAIC S INSURED Triangle Landscaping Inc. INSURER A:Erie Insurance Exchange 26271 Brad Lewis dba 3582 Fletchers Way INSURERS: Stem,NC 27581 INSURER C: 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 L TYPE OF INSURANCE ADD SUBR POLICY EFF POLICY EXP W LIMITS LTR INSR VD POLICY NUMBER (MM/DD/YYYYI IMM/DD/YYYYI GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY Q2726204479 03/26/2016 03/26/2017 DAMAGE TO RENTED PREMISES(Ea occurrence) $ CLAIMS-MADE X OCCUR MED EXP(Any one person) $ PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY JEC7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 750,000 (Ea accident) A ANY AUTO Q032630379 03/26/2016 03/26/2017 BODILY INJURY(Per person) $ ALLOWNEDAUTOS BODILY INJURY(Per accident) $ X SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS °N - AND ANY PROPRIETOR/PARTNER/EXECUTIVE Q872600559 03/26/2016 03/26/2017 E.L.EACH ACCIDENT $ 100,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT_$ 500,000 A Contractor's equip Q272620479 03/26/2015 03/26/2017 Equipment 122,875 DESCRIPTION OF OPERATIONS/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 a THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Orange County g ty ACCORDANCE WITH THE POLICY PROVISIONS. PO Box8181 Hillsborough,NC 27278 AUTHORIZED REPRESElNT�ATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD