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DocuSign Envelope ID: 5084246A-7988-4068-804E-9127EAD179DB <br /> Erie CERTIFICATE OF INSURANCE <br /> Insurance° -THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY- <br /> ID-3 Ere Irvi PI . ENE:,PA 110510 CERTIFICATE HOLDER COPY <br /> NAME AND NUMBER OF AGENCY DATE ISSUED <br /> 09/01/2016 <br /> 105 HIARP131 A113NCA JJ 1 156 <br /> 1031 S MAIN 1,3! NAME AND ADDRESS OF CERTIFICATE HO,LDER , <br /> 0151A51/031300I3 , N 1/115 5758 336-227-4271 <br /> NAME AND ADDRESS OF NAMED INSURED <br /> ORANGE COUNTY <br /> NICE AND GREEN COMMERCIAL ATTN: TAMMY COMAR <br /> FLOOR CARE SERVICES LLC PO BOX 8181 <br /> 1940 CRAWFORD RD LOT 27 HILLSBOROUGH NC 27278— <br /> GRAHAM NC 27253-9077 <br /> This is to certify that policies,as indicated by Policy Number below,are in force for the Named Insured at the time that the certificate is being issued. <br /> POLICY POLICY —' <br /> TYPE OF INSURANCE POLICY NUMBER EXPIRA DATE LIMITS OP INSURANCE <br /> EFFECTIVE DATE TION <br /> _._..._..,.._ <br /> GENERAL LiABiLiTY 0253121000 01/31/2016 01/31/2017 EAci u occunnplcE s 1 0000 r-, <br /> COMMERCIAL GENERAL LIABILITY Hu <br /> OCCIJRRENCE LOAM FIRE DAMAGE <br /> GENIL AGGREGATE LIMIT APPLIES .(Arly Of 0'!.premses) 1000000 <br /> PER POLICY <br /> VOLUNTARY PROPERTY DAMAGE MED EXP(Any ono Eamon) S 5000 <br /> PERSONAL&ADV INJURY $ <br /> 1000000 <br /> GENERAL AGGREGATE S 2000000 <br /> pRoDucTs-COMPOP AGG$ 2000000 <br /> BODILY INJURY , , <br /> AUTOMOBILE LIABILITY 0100630737 10/06/2016 10/06/2017 (EACH PERSONO " 100000 <br /> ANY AUTO(OWNED,HIRED, BODILY N,.IURY S 300000 <br /> NON OWNED) (EACH ACCIDEN1) <br /> PROPERTY DAMAGE $ Inonon <br /> BODILY(N DRY AND s <br /> PROPERTY DAMAGE <br /> COMBINED <br /> 1 _ <br /> EACH OCCURRENCE <br /> AGGREGATE <br /> — ,......, <br /> STATUTORY <br /> EGO O LY ACCIDENT $ EACH ACCIDENT <br /> INJURY DISEASE S POLICY MT <br /> .1 1 BY DISEASE S. EACH EMPLOYEE <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> CANCELLATION:SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> DELIVERED 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 terms and <br /> 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 <br /> endorsernent(s), <br /> THIS CERTIFICATE IS ISSUED FOR INFORMATION PURPOSES ONLY AND ERIE INSURANCE <br /> CONFERS NO RIGHTS ON THE CERTIFICATE HOLDER.IT DOES NOT <br /> AFFIRMATIVELY OR NEGATIVELY LIST,AMEND,EXTEND OR OTHERWISE <br /> ALTER THE TERMS,EXCLUSIONS AND CONDITIONS OF INSURANCE <br /> COVERAGE CONTAINED IN THE POLICY(IES)INDICATED ABOVE.THE TERMS SEE REVERSE SIDE <br /> AND CONDITIONS OF THE POLICY(IES)GOVERN THE INSURANCE COVERAGE <br /> AS APPLIED TO ANY GIVEN SITUATION.LIMITS SHOWN MAY HAVE BEEN <br /> REDUCED BY CLAIMS PAID.THIS CERTIFICATE OF INSURANCE DOES NOT <br /> CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER AND CERTIFICATE HOLDER. AUTHORIZED /1‘4,..„ I <br /> REPRESENTAINE <br /> UE-15(18 0911 2 CIF <br />