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DocuSign Envelope ID: C5CllFD4- 56CD- 48FD- BBD1- 95F2AFF7112B <br />Erie CERTIFICATE OF INSURANCE <br />hczi it A nrAQ —THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION ONLY <br />Home Office • 100 Ere Insurance Place • Erie, Pennsylvania 16530 • 814870.2000 <br />Toll free 1.800.458.0$11 • Fax 814.670.3126 • www.erleinsurer)ce.com <br />NAME AND ADDRESS OF AGENCY THE BALLARDAGL:NCY AGENT'S NO. <br />105 W KING ST .131010 <br />HILLSBOROCJGFI, NC 27278-2543 <br />(919)732 -2138 <br />RES$ OF NAMED INSURED <br />HISTORIC HILLSBOROUGH <br />COMMISSION <br />PO BOX 922 <br />HILLSBOROUGH, NC 27278 <br />ERAL LIABILITY <br />COMMERCIAL GENERAL LI <br />❑ CLAIMS MADE ❑ <br />L AGGREGATE UMIT APPLIES <br />POUCY ❑ PROJECT ❑ <br />AUTOMOBILE LIABILITY <br />"ANY AUTO" OMED <br />OWNED <br />HIRED <br />NON-OWNED <br />ESS LIABILITY <br />OCCURRENCE <br />RETENTION S <br />E! IEMWORKERS C MPENSAYTION & Q86 0600392 216118 I 216119 <br />LIABIL <br />DATE ISSUED (MMInDfYYI <br />1123118 <br />'his certificate is Issued for information purposes only and confers <br />o rights on the certificate holder, It does not affirmatively or <br />egad y amend, extend, or otherwise alter the terms, exclusions <br />ind conditions of insurance coverage conlalned In the policy(ies) <br />ndlcated below. The terms and condtions of the policy (ies) govern <br />he Insurance coverage as applied to any given situation. Limits <br />hown may have been reduced by cialms paid. This certificate of <br />nsurance does not constitute a contract between the Issuing <br />nsurer(s), authorized representative or producer and the <br />;art €heats holder. <br />LIMITS <br />EACH OCCURRENCE <br />FIRE DAMAGE (Any One Fire) <br />MED EXP (ky One Perwnl <br />PERSONAL 8 ADV. INJURY <br />GENERAL AGGREGATE. <br />PRO DU CTS- COMPICPAGG <br />BODILY INJURY <br />[EAftI PERSONy S <br />PROPERTYOAMAGE S <br />SODILY INJURY AND <br />PROPERTY DAMAGE S <br />rnuriusn <br />IDILY ACOiDENT 5 500,000 EACH ACCIDENT <br />J11TIY DISEASE S 500.000 POLICY LIMIT <br />BY DISEASE S 500,000 EACH EMPLOYEE <br />CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION [LATE THEREOF, NOTICE WILL BE DELIV- <br />EREO IN AGGORDANCE 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 lied of such endorsement (s). <br />NAME AND ADDRESS OF CERTIFICATE HOLDER <br />Orange County Human Services AUTHORIZED REPRESENTATIVE <br />Agency <br />PO Box 8181 <br />Hillsborough, NC 27278 <br />EIG6230 8111 // Page 1 of 1 <br />L �l <br />I. <br />