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DocuSign Envelope ID:50421254-FB36-44AO-8278-OB76332BF8AD <br /> sI Erie CERTIFICATE OF INSURANCE <br /> � �" Insurance® -THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY- <br /> 100 Erie Ins.PI.• Erie,PA 16530 CERTIFICATE HOLDER COPY <br /> NAME AND NUMBER OF AGENCY DATE ISSUED 0211912❑19 <br /> THE SOROI INSURANCE AGENCY INC JJ1095 <br /> 16 CONSULTANT PL STE 102 NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> OURHAM, NC 27707-6313 919-682-4814 <br /> NAME AND ADDRESS OF NAMED INSURED <br /> ORANGE COUNTY <br /> TRIANGLE LANDSCAPING INC 19 <br /> �O Box s I1 <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 /> _ _ _ _ ;;;r�F�fF <br /> i1.... .::::::::.::...:::::. -- ............ ;:-;;;:-;:#.rQl.E.1`x�.....i....i s:=;:=:=>:=:=>: --ri------....,..................--------------........... <br /> P10E:::>::>::>::::::::>:::::::;::;::::>::>:=:FD1 tDV H N18�CR:;:-;:.;::::::::::::::::::.;--::.:::::.;:.:_:-; >:-::.::.:_:....i3QA1T�1 E:::>::::>::::;::::>::::;:::::>>:::_:::::>:::>.::>::>:::z:: <br /> a" ............... U....- .... <br /> FE£11H>4`Eli]_w L�14 CIw <br /> ............. ...... 7 , ,rrr• <br /> GENERAL LIABILITY Q272620479 03/2612019 03/26/2020 EACH OCCURRENCE s 100O0D0 <br /> CO M M ERC IAL G EN ERAL L IABI LITY <br /> OCCURRENCE FORM FIRE DAMAGE <br /> GEN'L AGGREGATE LIMIT APPLIES (Any one pn mfses) 1000000 <br /> PER:PROJECT <br /> MED E7fP(Any one person) $ <br /> 500❑ <br /> PERSONAL B ADV INJURY $ <br /> 1000000 <br /> GENERALAGGREGATE $ <br /> 2000000 <br /> PRODUCTS-COMP1010 AGG s <br /> 2000000 <br /> BODILY INJURY <br /> S <br /> AUTOMOBILE LIABILITY 0032630379 0312612C19 03/26/2020 EACH PERSON) <br /> 1 <br /> ANY AUTO{OWNED,HIRED, BODILY INJURY <br /> NON-OWNED) <br /> EACH ACCIDENT) $ <br /> PROPERTY DAMAGE $ '- >'-'- <br /> BODILY INJURY AND <br /> PROPERTY DAMAGE $ 750000 <br /> COMBINED <br /> EACH OCCURRENCE ----------------- <br /> {yF`F•�. ' <br /> AGGREGATE <br /> ff <br /> WORKERS COMPENSATION Q872600559 03/26/2019 03/26/2020 <br /> STATUTORY �'`•'' �; '=AND BODILY BODILY ACCIDENT $ EACH ACCIDENT <br /> EMPLOYERS LIABILITY INJURY DISEASE $ 500000 POLICY LIMIT <br /> BY DISEASE $ 500000 500000 EACH EMPLOYEE <br /> DESCRIPTION OF OPERATiONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <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 policy(ies)must be endorsed.It SUBROGATION IS WAIVED,subject to the terms and <br /> conditions of the policy,certain policies may require an endorsement.A statement cn 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 /> OF-1568 09112 CIF REPRESENTATIVE Ate, <br />