Orange County NC Website
Browse       Search
DocuSign Envelope ID:62D5D1EC-135513-43A&AA136-9135139CCE2973 <br /> �1�8Erie CERTIFICATE OF INSURANCE DATE ISSUED(MI"DIYY) <br /> I nsuranae —THIS CERTIFICATE IS ISSUED AS A(NATTER OF INFORMATION ONLY— 11120/18 <br /> Hoene Office • 1 Do Erie Insurance Place • Erie,Pennsylvania 16530 - 814.870.2000 <br /> TvI1 free 1.800.458.0811 • Fax 814.870.3126 •vv*w.erielnsurance.cvm <br /> NAME AND ADDRESS OF AGENCY LONG INS[IRANCF SERVICES AGENT'S No. <br /> 311 S RAIN ST ]71319 - M camla <br /> 10ERNERSVdLL1,NC 27284-2772 CO.:E 12e I demRAH£v.CITY IN AC ne I °I p In NY e <br /> (336)992-5664 This certificate Is Is Issued for Irdormatlon purposes only and confers <br /> NAME ANDADORESS0FNAMEDINSURED no rights on the certificate holder.It does net affirmatively or <br /> negatively amend extend,or otherwise after the terms,exclusions <br /> Carolina Parking&Entry and conditions et?Insurance coveragge contained In the pollcypps) <br /> Systems LLC Indicated below,The termsand candltlons of the polleyges)govern, <br /> the Insurance coverage as ap,pfled to any given situation.Limits <br /> 301`I winwood Road shown may have been reduced by claims paid.This cert€flcate of <br /> Clemmons,NC 27012 insurance does not constitute a contract between the Issuing <br /> lnsurar(s),authorized representative or producer and the <br /> certificate holder, <br /> This Is to certify that pollclesas Indicated by the Polley Number below are En force for the Named Ensured at the tires that the Cerdflcate.Is beln lssue . <br /> 0I Gf - .fILIGY htl3 _ fJMITS. <br /> C GENERAL LIAB€LtTY {32 0723264 8I7f]8 8l7119 EAc1r 4CCURRENCI< 2 000 000 <br /> ®CUMMERCWL GENERAL tJABiErtY nRE_➢AMAGF .kfm S 2,000,000 <br /> ❑CLAIMS MADE ®OCCu MED l%P: Iina f 5,000 = <br /> ❑ PERSQIPIiL&Aav l ADO S 2,000,000 <br /> ❑ Gikl`IALAGGREGATE 4,000,000 <br /> GEN'LAGGREGATE UM IT APPUES PER PRODUCfs C4HtPffiko 4,000,000 <br /> ®P41L9GY ]PR0IECT ❑LCC . <br /> C❑ AUTOMOBILE LIABILITY BOD1I1 INJURY <br /> 31",ANYAUTO" OBI g°kHF Q08 073(?832 817/19 817/19 p y *� ` <br /> OWNED Biyj <br /> Q a <br /> ®HIRED PROPF#TY➢AMAGE $ �'? r�" <br /> ®NON-OWNED <br /> �� <br /> B0DILYINJURYANO:. <br /> ❑GARAGE PR0f3l SiNED G PEITIYDAMAE $ 1,000,000 <br /> C❑EXCESS t tABIIlTY Q32 0770221 817118 8f7119 ,..CURREHCE 2 000,000r ,7 <br /> ®OCCURRENCE <br /> ` AGGREGATE 2,000,000 <br /> t- - <br /> ❑RETENTION S <br /> t. <br /> C IWORIKERS COMPENSATION& 92 0700659 817I18 817119 <br /> EMPLOYERS UABILFTY 80®11Y ACCIDENT $` 1,000 000 EACH ACCIDENT <br /> t( 4 DISEASE $ 1,000,000 POLM L(MIT <br /> OTHER DISEASE $ 1,000,000 EACH EMPLOYEE <br /> DESCRIPTION OF OPERATIONSILOCATIONSNEHIGLESIUCLUSIONS ADDED BY ENBORSEME?ITISPEGIAL 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 pollcy(les)most 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 endorsement(s). <br /> NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> Orange County AUTHORIZED REPRESENTATIVE <br /> PO Box 8181 <br /> Hillsborough,NC 27278 <br /> EIG6230 811# <br /> Page 1 of 1 <br />