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DocuSign Envelope ID: E08ABF96-EFE8-442B-BAD8-3439881BAE81 <br /> ,Erie s CERTIFICATE OF INSURANCE <br /> 1�►� insurance -THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY- <br /> 100 Erie Ins.PI.• Erie,PA 16520 CERTIFICATE HOLDER COPY <br /> NAME AND NUMBER OF AGENCY DATE ISSUED 0 211 912 0 1 9 <br /> THE SORGI INSURANCE AGENCY INC JJ1095 <br /> 16 CONSULTANT FL STE 102 NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> ❑URHAM,NC 27707-6313 919-682-4814 <br /> NAME AND ADDRESS OF NAMED INSURED <br /> ORANGE COUNTY <br /> TRIANGLE LANDSCAPING INC au PO BOX 8181 <br /> PO BOX 144 HILLSBOROUGH NC 27278- <br /> STEM NC 27581-0144 <br /> This Is to certify that policies,as Indicated by Policy Number below,are In force for the Named Insured at the time that the certificate Is being Issued. <br /> a <br /> ` <br /> GENERAL LIABILITY Q272620479 03/26/2019 03/26/2020 EACH OCCURRENCE $ 1000000 ` <br /> COMMERCIAL GENERAL LIA131LITY _ <br /> OCCURRENCE FORM-. FIRE DAMAGE <br /> QEN'L AGGREGATE LIMIT APPLIES (Any one premises) 1000000 <br /> PER:PROJECT <br /> MF20 EXP(Any we person) $ 5000 <br /> - <br /> PERSONAL 8 ADV INJURY $ 1000000 - -- k <br /> GENERAL AGGREGATE $ 2000000 <br /> PRODUCTS-COMPIOPAGG$ 2000000 <br /> -: <br /> BODILY INJURY $ <br /> AUTOMOBILE LIABILITY Q032630379 03/26/2019 0312612020 (EACH PERSON) <br /> ANY AUTO(OWNED,HIRED, BODILY INJURY `•--:�=-:--: ---- <br /> NON-OWNED) CH ACCIDEN <br /> PROPERTY DAMAGE <br /> r' x <br /> BODILY INJURY AND $ 750UD0 j <br /> PROPERTY DAMAGE - <br /> COMBINED \' <br /> EACH OCCURRENCE _ <br /> AGGREGATE <br /> WORKERS COMPENSATION Q872600559 03/26/2019 03/26/2020 STATUTORY <br /> i <br /> AND BODILY ACCIDENT $ EACH ACCIDENT <br /> EMPLOYERS LIABILITY INJuaY DISEASE $ 500000 POLICY UMIT <br /> BY DISEASE $ 500000 EACH EMPLOYEE <br /> _L _L 1 500000 <br /> DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS - <br /> I <br /> i <br /> r <br /> CANCELLATION:SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE <br /> DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the poiloy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and <br /> 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 <br /> endorsement(s). <br /> THIS CERTIFICATE IS ISSUED FOR INFORMATION PURPOSES ONLY AND ERIE INSURANCE <br /> CONFERS NO RIGHTS ON THE CERTIFICATE HOLDER.IT DOES NOT <br /> AFFIRMATIVELY OR NEGATIVELY LIST,AMEND,EXTEND OR OTHERWISE <br /> ALTER THE TERMS,EXCLUSIONS AND CONDITIONS OF INSURANCE <br /> COVERAGE CONTAINED IN THE POLICY(IES)INDICATED ABOVE.THE TERMS SEE REVERSE SIDE <br /> AND CONDITIONS OF THE POLICY(IES)GOVERN THE INSURANCE COVERAGE <br /> AS APPLIED TO ANY GIVEN SITUATION.LIMITS SHOWN MAY HAVE BEEN <br /> REDUCED BY CLAIMS PAID.THIS CERTIFICATE OF INSURANCE DOES NOT <br /> CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED , <br /> REPRESENTATIVE OR PRODUCER AND CERTIFICATE HOLDER. AUTHORIZED ' <br /> IMF-1668 asl12 CIF REPRESENTATIVE <br />