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DocuSign Envelope ID:7249DADO-19FF-4COE-88F9-EA556OE34ED7 <br /> 1 Erie DATE ISSUED(MMIDI)n <br /> ill CERTIFICATE OF INSURANCE <br /> 3/18/20 <br /> I nsurani —THIS CERTIFICATE IS ISSUED AS A{NATTER OF INFORMATION ONLY-- <br /> Home Office • 100 Erie Insurance Place • Erie,Pennsylvania 1653D • 514.870.2000 <br /> Toll free 1.800.458.0811 • Fax BK4 703126 • www.erieinsurance.com <br /> NAMEANDADDRESS OFAGENCY ULTIMATE CHOICE INS GROUP INC AGENT'S NO. <br /> Cq.;-�ERI SURA C_CO PANY.____. <br /> 3901 BARRETT DR STE 312 JJ 1520 CO,:: ERIE INSURANCE PROPERTY&r_A_SU_A-LTY G MPANY <br /> Co,:IFERIE INS1lRANCE EXCAN HGE /Nut Applicable <br /> RALEIGH,NC 27609-6611 ErielndemnityGCo. Attorney-in-Fact\Y�RK.in NY ..-.- <br /> .L.F�EJIVSI�AN_��P_��N��1�EW- <br /> (919)772-7698 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 /> DRAIN EXPRESS INC and conditions of insurance coverage contained in the policy(ies) <br /> indicated below.The terms and conditions of the policy(ies}govern <br /> PO BOX 670 ithe insurance coverage as applied to any given situation.Limits <br /> CARRF30R0.NC 27510 shown may have been reduced by claims paid.This certificate of <br /> insurance does not constitute a contract between the issuing <br /> insurers}, authorized representative or producer and the <br /> certificate holder. <br /> This is to Celt that licies ras indicated the Pplic Number below,are in farce for the Named insured at the time that the Certificate is belrr�ssued. <br /> Go Add11 POLICY NUMBER Y LIMITS <br /> LTR :._., TYPE Or INSURANCE _ <br /> E ❑GENERAL LIABILITY Q28 0123731 4/1/19 4/I/2Q EACH OCCURRENCE 1,0D0 000 <br /> 0 COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any One Fire) <br /> [—]CLAIMS MADE 0 OCCU MED EXP(Any One Perm) 5,000 <br /> ❑ PERSONAL&ADV.INJURY 1,000,000 <br /> ❑ GENERAL AGGREGATE 2,000,000 <br /> GEN'tAGGREGATELIMlTAPPLIESPER: PRODUCTS-COMPIDPAGG 2,000.000 <br /> ❑X POLCY [:]PROJECT ❑LOCI <br /> AUTOMOBILE LIABILITY BODILYINJURY <br /> ❑ <br /> TEACH PERSON) $"ANYAUTD (OWNED <br /> NON 6VINED) BODILY INJURY <br /> ❑ OWNED EACHACCIDET $ <br /> ❑ HIRED PROPERTY DAMAGE $ <br /> ❑ NON-OWNED BODWYINJURYAND <br /> PROPERTY <br /> $ <br /> ❑ GARAGE <br /> E ❑EXCESS LIABILITY EACH DCCURRENGE S 1,000,000 <br /> © OCCURRENCE Q28 0172305 4/1/19 4l1120 AGGREGATE $ 1,000.000 <br /> ❑ RETENTION $ 0 $ <br /> E WORKERS COMPENSATION 8 Q88 0104584 4/1/19 4/1/20 ACCIDENT $ 300,000 EACH ACCIDENT <br /> EMPLOYERS LIABILITY BOUfLY <br /> INJURY DISEASE $ 500.000 POLICY LIMIT <br /> i BY DISEASE 500,000 EACH EMPLOYEE <br /> OTHER <br /> I <br /> OESC RIPTION OF OPERATIONS/LOCATIONS/VEHIGLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br /> CANCELLATION: SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION DATE THEREOF,NOT ICE WILL BE DELIV- <br /> ERED IN ACCORDANCE WITH THE POLICY PROVISIONS. <br /> IMPORTANT: It the certificate holder is an ADDITIONAL INSURED,the policy(ii 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 tin the certificate holder in lied of such endorsemcnt(s). <br /> NAME AND ADDRESS OF CERTIFICATE HOLDER <br /> ORANGE COIJNTY ASSET MANAGEMENT AUTHOR12EDREPRESENTATIVE <br /> 306 REVERE ROAD <br /> HILLSBOROUGH,NC 27278 - <br /> �/ � Z" <br /> E106230 8111 Page 1 of I <br />