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DocuSign Envelope ID: E7CD6EF8-BFD4-4232-B1F7-CA4E6612A1AB <br /> OP ID: DR <br /> CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODNYYY) <br /> ka � 1 04/18/2016 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsements. <br /> PRODUCER Phone:919-682-4814 rciAAWT C Christine Barnett <br /> The Sorgi Insurance Agency PrIONE FAX 919-682-4906 <br /> 16 Consultant Plaice Suite 102 Fax:919.682 490fi ,c,No_Exty:919-6$2at814 Arc No . <br /> Durham,NC 27707 E-MAIL RESS:chris@a sorgiinsurance.com <br /> James E.Sorgi,CIC PRODUCER TRIALAI�1 <br /> CU5 O ER 1D#, . <br /> INSURENN AFFORDING COVERAGE _ _ NAIC <br /> INSURED Triangle Landscaping Inc. INSURERA:Erie Insurance Exchange 26271 <br /> Brad Lewis dba INSURERB: <br /> 3582 Fletchers Way <br /> INSURER G <br /> Stern,NC 27581 <br /> INSURER O: <br /> INSURER E: ... <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSRFTOLI TYPE OF INSURANCE ADDL UB POLICY NUMBER MMIDCY EFF LICDY EkP LIMITS <br /> LTR <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 <br /> 0312612016 03/26/2017 aA��rENrED <br /> X COMMERCIAL GENERAL LIABILITY Q2726204479 PREMISES(Eaoccurrsnce S <br /> CLAIMS-MADE I••I OCCUR MEO EXP(Any one person) $ <br /> PERSONAL&ADV INJURY $ _ 1,000,00 <br /> GENERAL AGGREGATE $ 2,000,00 <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP ACG S .2,000,00 <br /> POLICY PRO- LOCJECT <br /> S <br /> AUTOMOBILE LIABILITY COMEINED SINGLE LIMIT $ 750,OD <br /> (Ea acdcleni] <br /> A _ ANY AUTO Q032630379 @31261201fi 0312fi12017 BODILY INJURY(Per person) $ <br /> ALL OVMEO AUTOS BODILY INJURY(Per acddent) $ <br /> X SCHEDULED AUTOS PROPERTY DAMAGE ... <br /> $ <br /> HIRED AUTOS (Per accident) <br /> NON-OWNEDAUTOS S ..- <br /> $ <br /> UMBRELLALiAB OCCUR EACH OCCURRENCE $ <br /> EXCESSUAB I <br /> I CLAMS-MADE AGGREGATE _..-- <br /> DEDUCTIBLE _-_ $ ...._ <br /> RETENTION $ $ <br /> C STAT <br /> WORKERS COMPENSATION X VRy-MU- OTH- <br /> AND EMPLOYERS`LIABILITY OftY LIMIJS <br /> X ANY PROPRIETOWPARTNERIEXECUTIVE Y� NIA A {�872600559 0312612016 03126/2017 E.L.EACH ACCIDENT $ 100,@@ <br /> OFFICERIMEMBER EXCLUDED? 100 oo <br /> (Mandatary In NH) E.L.DISEASE-EA EMPLOYE $ _ , <br /> IS yes,desuibe under <br /> DESCRIPTION OF OPERATIONS belowE,L,DISEASE-POLICY LIMIT $ 500,00 <br /> A Contractors equip Q272620479 03126/2015 03/2612017 Equipment 122,87 <br /> DESCRIPTION Or OPERATIONS I LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Orange County ACCORDANCE WITH THE POLICY PROVISIONS. <br /> PO Box8181 <br /> Hillsborough,NC 27278 AUTHORIZED REPRESENTATIVE <br /> Q 1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD <br />