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DocuSign Envelope ID: 3144FB80- 9280 - 4339- 9E5C- D9D2FDD81F90 <br />Erie CERTIFICATE OF INSURANCE <br />�� I nsurancer - 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 <br />THE SORGI INSURANCE AGENCY INC JJ 1095 <br />16 CONSULTANT PL STE 102 <br />DURHAM , NC 27707 -6313 919 -682 -4814 <br />NAME AND ADDRESS OF NAMED INSURED <br />TRIANGLE LANDSCAPING INC <br />PO BOX 144 <br />STEM NC 27581 -0144 <br />DATEISSUED 02/20/2017 <br />NAME AND ADDRESS OF CERTIFICATE HOLDER <br />ORANGE COUNTY <br />PO BOX 8181 <br />HILLSBOROUGH NC 27278— <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 />GENERAL LIABILITY <br />COMMERCIALGENERAL LIABILITY <br />OCCURRENCE FORM <br />GEN'LAGGREGATE LIMIT APPLIES <br />PER: POLICY <br />VOLUNTARY PROPERTY DAMAGE <br />AUTOMOBILE LIABILITY <br />ANY AUTO (OWNED, HIRED, <br />NON- OWNED) <br />Q272620479 1 03126/2017 1 03/2612018 <br />0032630379 1 03/26/2017 1 03/26/2018 <br />EACH OCCURRENCE J$ 1000000 <br />FIRE DAMAGE <br />(Arty ores premises) $ 1000000 <br />MED EXP (Any orre person) $ 5000 <br />PERSONAL & AD'V INJURY 1$ 1000000 li <br />GENERAL AGGREGATE $ 2000000 <br />PRODUCTS- COOM Plop <br />AGG$ 2000000 <br />BODILY INJURY $ <br />(EACH PERSON) <br />BODILY INJURY $ <br />EACH ACCIDEN <br />PROPERTY DAMAGE $ <br />BODILY INJURY AND <br />PROPERTY DAMAGE $ 750000 <br />COMBINED <br />EACH OCCURRENCE <br />AGGREGATE <br />WORKERS COMPENSATION Q872600559 03/26/2017 03126/2018 STATUTORY s <br />AND BODILY ACCIDENT $ 100000 EACH ACCIDENT <br />EMPLOYERS LIABILITY INJURY DISEASE $ POLICY LIMIT <br />1 BY DISEASE $ 500000 1 00000 EACH EMPLOYEE <br />DESCRIPTION OF OPERATIONSjLOCATIONS NEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />L;ANL;hLL.A I IVN: bNUULU ANY Ur I Nt AtSUVL DLSCHlbLD POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE <br />DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br />IMPORTANT: It the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. II 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 <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 <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. <br />OF -1568 09112 CIF <br />ERIE INSURANCE <br />AUTHORIZED <br />REPRESENTATIVE <br />SEE REVERSE SIDE <br />