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DocuSign Envelope ID:8FB10AE2-FF42-455E-B977-09A898706984 <br /> zqErie CERTIFICATE OF INSURANCE DATE ISSUED(MMIDONY) <br /> z.. I nsurancY -THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY— 8/16/17 <br /> Nome Office - 100 Erie Insurance Place - Erie,Pennsylvania 16530 • 814,870.2000 <br /> Toll free 1.800.458.0811 - Fax 814,870.3126 • www.edehaurame.com <br /> NAME AND ADDRESS OF AGENCY LONG INSURANCE SERVICES AGENT'S NO, <br /> 311 S MAIN ST Jg1319 <br /> ICERNERSVII.LE,NC 27284-2772 Co"E rieElllldeDmnANCLo 1toAn®�in-Fact o in cah e <br /> (336)992-5664 This certificate Is Issued for information purposes an and confers <br /> NAME AND ADDRESS OF NAMED INSURED no rights an the certificate holder,It does not aff[rmativaiy or <br /> negatively amend,extend,or otherwise alter the terms,okoluslons <br /> Carolina Parking&Entry and eDrlditions of Insurance coveraga contained In the policy(les) <br /> Systems LLC Indicated below.The terms and conditions of the pal€cy(les)govern <br /> the insurance coverage as applied to any given situa lon,Limits <br /> 301 Twinwood Road shown may have been reduced by claims paid.This certificate of <br /> Clenamons,NC 27012 Insurance does not constitute a contract between the Issuing <br /> insurer{s); authorized representative or producer and the <br /> certificate holder. <br /> This Is to certify that pollcies,as Indicated by the Policy Number below,are in farce for the Named Insured at the time that the Certificate Is beInq Issued, <br /> =` P{11 G�iillhtBtR. _ 111ui3T5';" � ,c _iVl'EOIFINSU[trtifV4F, _ <br /> C❑GENERAL LIABILITY 8I7117 817/18CII DCCURRENCI~ - 1 000 000 <br /> Q32 0721264 FIREDAViAGi i1c�Flre 1000 000 <br /> COMMERCIAL GENERAL LIABILITY <br /> ❑CLAIMS MADE ❑OCCU <br /> IHE61€7IP Olae Pcrs 10 000 <br /> ❑ PEIi WD' th"A"Y 1,000,000 <br /> r <br /> ❑ GEl7ERAi AGfirfiEGATE j` 2,000,000 <br /> GENT AGGREGATE LIMIT APPLIES PER Pf;fiDfiGTS-CUMPI�QPAfG 2000(100 � <br /> POLICY ❑PROJECT ❑LDG r, 3 <br /> ® AUTOMOBILE LIABILITY BDG]IYINIURY` 4F <br /> ❑"ANYALITO"(H6N ONEOJ}` (EACH PlASONJ �;` $ <br /> ❑OWNED <br /> .;LLf1113LYi JURY;" ; <br /> AOO r $ s =. <br /> ®HIRED PLlO3'EATYbALAAGErsr <br /> BO3DILY IfiftlR�'AND R Y 4❑NON OWNED Lt(IP€RfYDAFgAl T <br /> ❑ $ <br /> GARAGE sSOM$INEV, 5 _R <br /> ❑EXCESS LIABILITY FAl;tt4CCi18FIENCI? P ✓"" �- <br /> ❑OCCURRENCEIGR£GATI ,r <br /> ❑RETENTION S IS <br /> € s 5 T a <br /> C WORKERS COMPENSATION& •--',: <br /> EMPLOYERS LIABILITY Q92 0700659 817117 8f7118 ACCIDENT $ 100,000 EACH ACCIDENT <br /> 80A1L DISEASE $ 500,000 PnUCY LIMIT <br /> _N1: DISEASE 5 100,000 EACH EMPLOYEE <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/LUCATLO)NSNEHICLESIEHCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIV- <br /> ERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> IMPORTANT If the certificate holder is an ADDITIONAL INSURED,the policy(les)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 lieu of such endorsernent(s). <br /> NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> Orange County AUTHORIZE0 REPRESENTATIVE <br /> PO Box 8181 <br /> Hillsborough,NC 27278 <br /> EIG6230 8/11 <br /> Page 1 of 1 <br /> I <br />