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DocuSign Envelope ID:2D2617C6-D4AC-4OD4-85B2-275FO4B41BC6 <br /> Erie CERTIFICATE OF INSURANCE DATE ISSt1EDJMMIOBNY) <br /> I= nsurances 3/28/19 <br /> --THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY— <br /> �ome CM re - 100 Er+e insurance Place • Erie,Pennsylvania 16530 • 814.870.2000 <br /> To1I free 1 800.458.081 f • Fax 814.870.3126 • www.ereinsurance.com <br /> NAME AND ADDRESS OF AGENCY THE BALLARD AGENCY AGENT'S NO. CQM <br /> JJlf}lf} Co.; <br /> 105 W KING ST Ccz,;_ �ERIEINSURANCEPFiOPE U7 CO.MPhNY <br /> 1liLL5i3GROUGH,NC 2727$-2543 Co.:E RIE{NSURANCE EXCHANGE, IN tApplicahle <br /> rIe Indemnity Co.,Attor yOF Fact In Y <br /> o�F _.RAIU( �UfJPANY OF NE <br /> (91 9)732-215$ This certificate is issued for information purposes only and confers <br /> NAME AND ADDRESS OF NAMED INSURED no rights on the certificate holder. It does not affirmatively or <br /> negatively amend,extend,or otherwise alter the terms,exclusions <br /> MATTHEW S JARRELL LAND and conditions of insurance coverage contained in the policy(ies) <br /> SURVEYING PLLC indicated below.The terms and conditions of the policy(ies)govern <br /> the insurance coverage as applied to any given situation.Limits <br /> 314 YORKTOWN DR, shown may have been reduced by claims paid.This certificate of <br /> insurance does not constitute a contract between The issuing <br /> CHAPEL 1 HILL,NC 27516 insurer(s), authorized representative or producer and the <br /> cerfificate holder. <br /> This is to mrtffy that policies,as indicated by the Polly Number below,are in force for the Named Insured at the time that the Certificate is being issued. <br /> TYPE OF INSURANCE POLICY NUMBER Wmby# LIMITS <br /> E ❑GENERAL LIABILITY© 22• 22 (] EACH OCCURRENCE 1.000 000 COMMERCIAL GENERAL LIABILITY Q3Q 77t70907 C�Ii lti fil«II <br /> FIRE DAMAGE(Any aneFin=, 1,[}[1[][1[10 <br /> ❑CLAIMS MADE ®OCCUR MED EXP An OnePersunj $ 5,000 <br /> ❑ _ PER SONAL&ADV.INJURY 1.000.000 <br /> ❑ GENERAL AGGREGATE 2.000,000 <br /> GEN'L AGGREGATE LIMIT APPLIESPER, PRODUCTS•COMPIOPAGG 2,OUi]UUO <br /> Di POLICY El PROJECT ❑LOC <br /> E❑ AUTOMORILE LIABILITY BODILYINJURY <br /> ®"ANYAUTO"(OWNED HIRE , QOC 2230831 C12211$ G122119 (EACH PERSON) S <br /> ❑OWNED BOCHACCIDERY S <br /> ❑WEB PROPERTY DAMAGE $ <br /> ❑ NON-OWNED BODILYINJURYAND <br /> PROPERTYDAMAGE 1.0[1O,Ooo <br /> ❑GARAGE COMBINED S <br /> EXCESS LIABILITY EACHOCCURRENCE S <br /> ❑ OCCURRENCE AGGREGATE S <br /> S <br /> ❑RETENTION S S <br /> i WORKERS COMPENSATION& STATUTURY <br /> Q9[}22[}0715 612211$ fi12211�J <br /> EMPLOYERS LIABILITY BODILY ACCIDENT S 1.000,000 EACH ACCIDENT <br /> NJURY DISEASE S 1,000 000 POLICY LIMIT <br /> BY DISEASE $ 1,O0fl.000 EACH EMPLOYE <br /> OTHER <br /> DESCRIPTION Of OPERATIONSILOCATIONSNEHICLES/EXCL.IISIONS 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 policyfiesy 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 endorsement(s). <br /> DAME AND ADDRESS OF CERTIFICATE HOLDER <br /> Triangle land Conservancey AU HORIIEO NEPRI SENTATIVE <br /> 514 S. Dukc St. <br /> Durham,NC 27701 <br /> EIG6230 8I1 T <br /> Page i of 1 <br />