2016-747-E AMS - Triangle Landscaping storm drain replacement

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DocuSign Envelope ID:966098F7-0590-43EE-BE72-33DC7E49FD65 OP ID:DR CERTIFICATE OF LIABILITY INSURANCE DATE 04/18/201 YYI D411 a121}1 6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policypes) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and 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 endorserment(s. ACT PRODUCER Phone:919•682-4814 NAME.'- Christine Barnett The Sorgi Insurance Agency Fax: 919-682-0908 PHONE FAX 16 Consultant Place Suite 102 c o 1:919-6824814 _-. [Alc No,;919-682-4906 Durham,NC 27707 E-MAIL Chris@so iinsurance.com James E.Sorgi,CIC PRODUCER TRIALAN — CUSTOMER ID H: INSURERS)AFFORDING COVERAGE NAIC P INSURED Triangle Landscaping Inc. INSURERA:Erie Insure nce Exchange 26271 Brad Lewis dba - 3582 Fletchers Way INSURER B- __--- Stem,NC 27581 tNSURERC:INSURER D: INSURER E: ---- INSURER F: -- COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN SR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MMIDPOLIOfYYYYN IAMB Y.YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $_ 1,000,00 x COMMERCIAL GENERAL LIABILITY Q2726204479 03126/2016 0312612017 IR SISITO PREMISESI $ CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ - PERSONAL a AOV INJURY $ 1,000,00 ! GENERALAGGREGATE S 2,000,04 fl G_EHL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG $ 2,000,00 I POLICY PRO- LOC $ JE AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 750,Od A ANY AUTO Q032630379 03126/2016 0312612017 (Ea aocida -_ 60DILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per acddant) $ x SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per aaadenl) NON-OWNIEDAUTOS 3 $ UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CWMS4AADf=. AGGREGATE $ -- DEDUCTIBLE — S RETENTION S $ -- --- WORKERS COMPENSATION x WC STATU- - OTH- -- AND EMPLOYERS'LIABILITYLIMITS I I ER X ANY PROPRIETORIPARTNERIEXECUTiVE YIN N -872600569 0312612016 0312612017 F..L,EACH ACCIDENT S --- 100,00 OFFICERIMEMBER EXCLUDED? N I A (Myyandatory In NH) E.L.DISEASE-EA EMPLOYE $ _ 100,00 If bESCRIPT ON OF OPERATIONS beiaw E.L.DISEASE-POLICY LIMIT $ 500,00 AContraclors equip Q272620479 03126/2015 0312612017 Equipment 122,87 DESCRIPTION OF OPERATIONS I LOCATIONS?VEHICLES{Atlaeh ACORD 101.Additional Remarks Schedule,If mere space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County ACCORDANCE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX8181 Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE " 91988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered?narks of ACORD