2017-172-E AMS - Nice & Green Commercial to clean carpet Justice, West Campus Office Buildings

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DocuSign Envelope ID: 3A6DC95C-F02F-4889-9A56-571430E33C9F Ac®RD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 1/10/2017 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 CONTACT Martha Dickerson NAME: Lester Ins. Group, Inc. T/A The Harper Agency (A//CNNo.Extl: (336)227-4271 FAX (336)222-9467 1037 S. Main St. E-MAIL ADDRESS:martha.dickerson @harperinsurance.com INSURER(S)AFFORDING COVERAGE NAIC# Burlington NC 27216 INSURERA:Penn National Insurance Company INSURED INSURER B:Erie Insurance Exchange 26271 Nice and Green Commercial Floor Care Services, LLC INSURERC: 5104 S NC Hwy 49 INSURERD: Burlington, NC 27215 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:CL1711007596 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 ADDL SUBR POLICY EFF POLICY EXP TYPE OF INSURANCE LTR INSD WVD POLICY NUMBER IMM/DD/YYYY) (MM/DD/YYYY1 LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE X OCCUR PREMISES SES Ea occurrence) $ 1,000,000 GL9 0733918 1/31/2017 1/31/2018 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO PRODUCTS-COMP/OPAGG $ 2,000,000 X POLICY JECT- LOC OTHER: Automatic Additional lnsd $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) B ANY AUTO BODILY INJURY(Per person) $ 100,000 ALL OWNED SCHEDULED Q10-0630737 10/6/2016 10/6/2017 BODILY INJURY(Per accident) $ 300,000 AUTOS NON-OWNED PROPERTY DAMAGE $ 100,000 HIRED AUTOS AUTOS (Per accident) Underinsured motorist BI split $ 100,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE N/A E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) i Pik CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Fred Brooks ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 8181 Hillsborough, NC 27278 AUTHORIZED REPRESENTATIVE /� i Martha Dickerson/MHD ' 4` A"' '�«"'�" S� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401)