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DocuSign Envelope ID: lC642261-CBE7-4A85-A52B-E53079E564B7 <br /> �eqErie CERTIFICATE OF INSURANCE RATE}SSUER{MMIORIYYj <br /> hzv Insurance —THIS CERTIFICATE IS ISSUED AS A MATTER OE INFORMATION ONLY— GI I tPP I fi <br /> Home Office • 100 Erie Insurance Place • E­,Pennsylvania 16M • 814,870 2coo <br /> Toll free i.WJ.456.0811 • Fax 814,870-3126 • Wfi.eriehisurance.com <br /> NAME AND ADDRESS OF AGENCY HATCHLLOR&,A SSOC:IATES LL( AGENT'S N0, <br /> 1312 AiNNAP'OLIS L)R STF 202 JJ3439 <br /> Co.;D ERIE NSUITANCUROP 131-IF&CASUALTY COMPANY <br /> Rr11.1 ]Gll,NC 27608-2146 Co.:E �IE INSURA W E%rANGE Not Applicable <br /> r e Indemni 0., 0rn0 y_in fact _ In N_Y..-- <br /> Ca:F-ERIE 1N IT CE Cp IPANY�3 E i7RI _ <br /> { REI—) i-13i)t} This certificate Is Issued for Information purposes on and confers <br /> NAME AND ADDRESS OF NMtER I#asuREO T -` no rights nn the certificate holder.It does not atiirmallvel of <br /> egatively amend,extend,or otherwise alter the terms,exclusions <br /> AXIS L'{J+]S'I'It1JC"f I T+I N9r1IVACiEIVIFi+1'I' n <br /> and conditions of Insurance coveragge contained In the pol]cyties) <br /> 105 ATKINSON CT` indicated below.The terms and condtiions of the policy((]es)govern <br /> the Insurance coverage as applied to any given situatlan.Limits <br /> rll'F k,NC 27502 shown may have been reduced by claims paid.This certificate of <br /> Insurance does not constitute a contract between the issuing <br /> Insureds), authorized representative or producer and the <br /> certificate holder. <br /> This Is to cent that poilcies,as indicated Lay the.Pal�cy Number Lae flw�are-in force for the Named Insured at the tune that the Certificate Is being lssged <br /> pp <br /> Pt11ICYI Uh4BEti � i ' LIMITS --- <br /> } ]GENERAL LIABILITY 3 :EACH OCGORRENG E I i700 000 - <br /> COMMERCIAL GENERAL LIABILITY 0 I �(� 1 I I1/l$ 111]1 I <br /> i 1 FIRE DAMAGE Ori¢Firs 1 000,000 . <br /> CLAIMS MADE OCCUR M€D EXP OntPt= 5,000 <br /> ❑ -- — - ' PERSONAL&ADV.INJURY 1,000,000 _ <br /> G€NEIMAGGREGATE ?,000.000 <br /> 6 ENT AGGREGATE LIMIT APPLIESPER [ PRODUCIS-COAIPIOPAGG 2,000 000 <br /> ❑PDUCY �PRUCT ❑LOC <br /> AUTOMOBILE LIABILITY <br /> ❑"ANYAUTO°t° 1 a°t+I E B<FACII INJURY <br /> RSO g <br /> []OWNED I BO(EXIL UFPRY. g <br /> ❑HIRED 1 PHOAERTYDAMAGE is <br /> El NOWOWNED ROT1tLYIN IURYANd <br /> []GARAGE [ PROPERTY DAMAGE f <br /> iF-1 EXCESS LIABILITY CORNED $ I <br /> ERGIt#]CCURBENCE S <br /> ❑OCCURRENCE { AOGREGA1t <br /> i <br /> ❑RETENNON S <br /> I <br /> EJ WORKERS COMPENSATION <br /> EMPLOYERS LIABILITY Q95 0102849 1 111115 3 I!I116 ACCIDENT S 1,000,000 EACH ACCIDENT <br /> BODE N URYi <br /> Y DISEASE S 1'000,000 POLICYIJMfT <br /> f BY .. DISEASE S 1,000,000 EACH EMPLaYEE ' <br /> OTHER <br /> I <br /> DESCRIPTION OF OPERATHINSJLOGATIONSNE#IICLESIEXCLUSIONS ADDED DY ENDORSEMENT/SPECIAL PROVISIONS <br /> CANCELLATION: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION HATE 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(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 lieu of such endorsenment(s). <br /> r <br /> ME AND ADDRESS OF CERTIFICATE HOLDER <br /> t`JRANGf'COLJNI'Y GOVERNMENT. AUTHORIZE 1P8 s TIV <br /> 1'O BOX S i s I <br /> HILLSBOROLlC,1{, 1C: 27278 <br /> EIG6230€3111 <br /> Page 1 of t <br />