Orange County NC Website
Browse       Search
DocuSign Envelope ID:531F1F4A-1081-458D-9659-BCA1704AD803 <br /> DocuSign Envelope ID;586EZA42-AESD-4C6D-A276-C4A22C16ADD7 <br /> r Erie CERTIFICATE OF INSURANCE <br /> �. Insurancer THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY- <br /> 10f]Eno Ins.PI.•€rle,PA 16530 CERTIFICATE HOLDER COPY <br /> NAME AND NUMBER OF AGENCY DATE ISSUED <br /> THE SORG{INSURANCE AGENCY INC JJ 1095 CI212012017 <br /> 16 CONSULTANT PL STE 102 NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> DURHAM, NC 27707-6213 919-682-4814 <br /> NAME AND ADDRESS OF NAMED INSURED <br /> TRIANGLE LANDSCAPING INC ac PO BO E COUNTY <br /> 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 /> ...n p £ g13 .s kFlf1R ate �h :t $ � RITt 11k1A1tC Ym t£ :: <br /> GENERAL <br /> ENER CLAL LIABILITY <br /> LIABILITY IT4� Q272820479rt 03/26/2017 03/26/2018 EACH OCCURRENCCOMMEE <br /> .s 1000040 <br /> OCCURRENCE FORM �€� <br /> GEN'L AGGREGATE LIMIT APPLIES P1RE DAMAGE S n <br /> (Any oAapremiseal 1000000 fir&& <br /> PER:POLICY <br /> VOLUNTARY PROPERTY DAMAGEMED E1P(Anyone person) x <br /> 500C} { <br /> i; r£#' ..r'3sk4... <br /> � i <br /> PERSONAL BADVINJURY $ 100G004 . <br /> GEN ERAL AGGREGATE S # .`3s , <br /> uW -- --PRODUCTS-COMPIOP A $ 2000000 <br /> :. , <br /> '£ 3 <br /> i :'• --h - <br /> AUTOMOBILE LIABILITY 0032630379 03/26/2017 03/26/2018 B cHP SON s - <br /> ANY AUTO(OWNED] HIRED, {EA ? s•,_, •.�• ,wFa <br /> NON-OWNED] EACHBODIL CIIC+tIDEN <br /> PROPERTY DAMAGE $ '.£.=:• ;: ;: <br /> BODILY INJURY AND <br /> PROPERTY DAMAGE $ 750000 <br /> COMBINED <br /> EACH OCCURRENCE y%t::f:, g i <br /> AGGREGATE - #: a <br /> sg" <br /> WORKERS COMPENSATION G872600559 03/26/2017 0312612018 STATUTORY <br /> AND BODILY ACCIDENT $ EACH ACCIDENT <br /> EMPLOYERS LIABILITY INJURY DISEASE s 1100000 <br /> 500000 POLICY LIMY <br /> BY DISEASE $ 100000 EACH EMPLOYEE <br /> DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br /> j <br /> i <br /> i <br /> r <br /> r <br /> i <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 PROVISONS. <br /> IMPORTANT:It the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.It 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 /> 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 /> OF-1S88 09J12 CI REPRESENTATIVE <br />