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DocuSign Envelope ID:9507D755-14CD-4FOC-A7AF-0B572F4D3DB8
<br /> ,,,,r1 Erie 444,il e CERTIFICATE OF INSURANCE DATE ISSUED(MM/DD/YY)
<br /> 8/28/17
<br /> Insurance° __THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
<br /> Home Office • 100 Erie Insurance Place • Ere,Pennsylvania 16530 • 814 870 2000
<br /> To free 1 800,458 0611 • Fax 814 870 3120 • vywvy et leinsurance corn
<br /> NAME AND ADDRESS OF AGENCY BAREFOOT INSURANCE GROUP INC AGENTS NO.
<br /> ...-m-: . 1 11, 1 01,•,1'
<br /> 2014 S MAIN ST ST E',606 113437 a.:D ERIE IN 1.111ANCEPMFERTY&CASUA T)(COMPANY )
<br /> NA7AKE l'OlEST„NC 275874339 Co.:E EpleElInNdSeUmRnA.NC EXCHANGE Not Applicable
<br /> Indemnity ou Attorney-In-Fact in NY
<br /> Go:E .:111E111/41SURANCE COMPANY NEW YORK
<br /> Co.:G "-TAGSHIP CITY INSURANCE COMPANY
<br /> (919)21"7-5870 This certificate is issued for information purposes only and confers
<br /> NAMEAN1AiDRESS OF NAMED INSURED no rights on the certificate holder. It does not affirmatively or
<br /> negatively amend,extend,or otherwise alter the terms,exclusions
<br /> ( PS MOBILE SOLUTIONS INC and conditions of insurance coverage contained in the policy(ies)
<br /> indicated below.The terms and conditions of the policy(Ies)govern
<br /> 920 PAVERSTONE DR sTE E2 the insurance coverage as applied to any given situation.limits
<br /> RALEIGII, NC 27615-4723 shown may have been reduced by claims paid.This certificate of
<br /> insurance does not constitute a contract between the issuing
<br /> insurer(s), authorized representative or producer and the
<br /> certificate holder.
<br /> This is to certify that policies,as indicated by the Policy Number below,are in force for the Named Insured at the time that the Certificate is being issued.
<br /> - oni1CY EFFECD1E FOUCY*'41"t:or , LIMITS
<br /> TYPE OF INS RANCE _ POLICY NUMBER. __ __ DATERIMiDDPLYL . areili r EACH occ
<br /> 1.Y.A44.e..
<br /> 1,000,000
<br /> ]GENERAL LIABILITY
<br /> Q97 0073701 9/4/16 9/4/17 RRE-0HAm, AGgI9u11,11y-EN.04clEitis_$
<br /> ' -
<br /> [xi COMMERCIAL GENERAL LIABILITY
<br /> 1 900,000
<br /> ,1 CLAIMS MADE NI OCCUR mER E,yp uny_yma Leri_s/N
<br /> 5 000
<br /> -
<br /> I . _ .._ i,itP,J7RoSoDuNAcTs..L Ag,07„pippIN44U6IIGY: ,11,i)0i0_60,6:0600(0)
<br /> E 1 GENERAL AGGREGATE 4__ _2,000,00k
<br /> GEN'L AGGREGATE OMIT APPLIES PER:
<br /> FS1 POLICY r 11 PROJECT I I LOC
<br /> F Eil AUTOMOBILE LIABILITY BODILY INJURY
<br /> "ANY AUTO"(OWNED HIRED, Q09 0430543 9/4/16 9/4/17 uml maul) $
<br /> BOO11.Y.INJURY
<br /> [Xi OWNED ‘F-ACKfiCOCIENTI — $
<br /> FS] HIRED PROPERTf DANIAGE $
<br /> [xi NON-OWNED BODILY INJURYAND
<br /> PROPERTY DAMAGE $ 1,000,000
<br /> [Ti GARAGE COMBINED
<br /> 1,000,000
<br /> 9/4/17 $
<br /> F FIT EXCESS LIABILITY
<br /> Q33 0470171 9/4/16
<br /> LX1 OCCURRENCE Air GATE $ 1,000,000
<br /> -- -- $
<br /> H RETENTION $
<br /> --„,..-..---,..„-----
<br /> F WORKERS COMPENSATION& ......STATUTOR.Y.
<br /> _...., _
<br /> 9/4/17 ACCIDENT $ 1,000,000 EACH ACCIDENT
<br /> EMPLOYERS LIABILITY Q93 0400496 9/4/16 BODILY
<br /> INJURY DISEASE $ 1,000,000 POLICY LIMIT
<br /> BY DISEASE $ 1,000,000 EACH EMPLOYEE
<br /> OTHER
<br /> l
<br /> I 1
<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 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 /> ORANGE COUNTY AUTHORIZED REPRESENTATIVE
<br /> PC)I30X 8181
<br /> IIIII,SBOROUGI I,NC 27278 "
<br /> EIG6230 8/11
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