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DocuSign Envelope ID: 72E7BD50- E5C5- 4BEA- B4AA- FCA907469BF8 <br />r 2Erie CERTIFICATE OF INSURANCE <br />ol - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY - <br />100 Erie Ins. Pl. • Erie. PA 16530 CERTIFICATE HOLDER COPY <br />NAME AND NUMBER OF AGENCY <br />THE SORGI INSURANCE AGENCY INC 11 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 />DATE ISSUED 02/19/2018 <br />NAME AND ADDRESS OF CERTIFICATE HOLDER <br />ORANGE COUNTY <br />PO BOX 8181 <br />HILLSBOROUGH NC 27278— <br />1 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 ring issued. <br />GENERAL LIABILITY ! 0272620479 03/26/2018 03/26/2019 <br />COMMERCIAL GENERAL LIABILITY <br />OCCURRENCE FORM <br />GENT. AGGREGATE LIMIT APPLIES <br />PER: POLICY <br />VOLUNTARY PROPERTY DAMAGE <br />ANY O BILE LIABILITY � Q032630379 1 0312612018 I 03/26/2019 <br />NON - OWNED) <br />WORKERS COMPENSATION Q872600559 03/26/2018 03/2612019 <br />EACH OCCURRENCE <br />S 100()00() <br />FIRE DAMAGE <br />(Any one premises) <br />1000000 <br />MED EX.P (Any one person) <br />S <br />5000 <br />PERSONAL & ADV INJURY I S 1000000 <br />GENERAL AGGREGATE IS 2000000 <br />PIOP AGGI$ 2000000 <br />(EACH PERSON} $ <br />BODILY INJURY $ <br />(EACH ACCIDENT) <br />PROPERTY DAMAGE $ <br />BODILY INJURY AND g 750000 <br />PROPERTY DAMAGE <br />COMBINED <br />EACH OCCURRENCE <br />AGGREGATE <br />STATUTORY <br />AND BODILY ACCIDENT S 500000 EACH ACCIDENT <br />EMPLOYERS LIABILITY INJURY DISEASE S 500000 POLICY LIMIT <br />BY DISEASE $ 500000 EACH EMPLOYEE <br />DESCRIPTION OF OPERATIONSILOCATIONStVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL 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 <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 />4Tr�T►1 --1F T_N110 <br />AUTHORIZED <br />REPRESENTATIVE ^, �„_ _,. <br />SEE REVERSE SIDE <br />