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DocuSign Envelope ID:93D535A1-BE46-46DB-9F39-A847C7E79986 <br /> rAi <br /> Erie CERTIFICATE OF INSURANCE <br /> �\ Insurance -THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY- <br /> 100 Erie Ins.PI. • Erie,PA 16530 CERTIFICATE HOLDER COPY <br /> NAME AND NUMBER OF AGENCY DATE ISSUED <br /> 02/20/2017 <br /> THE SORGI INSURANCE AGENCY INC JJ 1 095 <br /> 16 CONSULTANT PL STE 102 NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> DURHAM , NC 27707-6313 919-682-4814 <br /> NAME AND ADDRESS OF NAMED INSURED <br /> ORANGE COUNTY <br /> TRIANGLE LANDSCAPING INC * PO BOX 8181 <br /> PO BOX 144 HILLSBOROUGH NC 27278— <br /> STEM NC 27581-0144 <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 /> ,..... U1NIT..5;4kF.1N&�1RAt+CGI�................................:::::: <br /> GENERAL LIABILITY Q272620479 03/26/2017 03/26/2018 EACH OCCURREN E <br /> c $ <br /> COMMERCIAL GENERAL LIABILITY 1000000 z: <br /> OCCURRENCE FORM <br /> FIRE DAMAGE <br /> GEN'LAGGREGATE <br /> LIMIT APPLIES (An one remises) <br /> PER POLICY <br /> VOLUNTARY PROPERTY DAMAGE MED EXP An <br /> ( Y one person)) $ <br /> 5000 <br /> PERSONAL&ADV INJURY $ <br /> 1000000 <br /> GENERAL AGGREGATE $ <br /> 2000000 <br /> PRODUCTS-COMP/OPAGG$ <br /> 2000000 <br /> BODILY INJURY <br /> AUTOMOBILE LIABILITY Q032630379 03/26/2017 $ <br /> 03/26/2018 (EACH PERSON <br /> ANY AUTO(OWNED,HIRED, BODILY INJURY <br /> NON OWNED) (EACH ACCIDENT) <br /> PROPERTY DAMAGE $ <br /> BODILY INJURY AND <br /> PROPERTY DAMAGE 750000 <br /> COMBINED <br /> EACH OCCURRENCE <br /> AGGREGATE <br /> STATUTORY <br /> S TORY <br /> WORKERS S C MPEN ATI <br /> O S ON 87 <br /> Q 26 559 <br /> 00 03/26/2017 <br /> 03/ 6/ 18 2 2 0 <br /> AND BODILY ACCIDENT $ 100000 EACH ACCIDENT <br /> EMPLOYERS LIABILITY INJURY DISEASE $ SOOOOO POLICY LIMIT <br /> BY DISEASE $ 1 00000 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 /> endorsement(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 <br /> REPRESENTATIVE <br /> OF-1568 09/12 CIF <br />