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<br />DocuSign Envelope ID: 970C507C-F8DD-4D99-B4F2-ADC24286F4B8 <br />OP ID: C1 <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />04/29/2015 <br />THISCERTIFICATEISISSUEDASAMATTEROFINFORMATIONONLYANDCONFERSNORIGHTSUPONTHECERTIFICATEHOLDER.THIS <br />CERTIFICATEDOESNOTAFFIRMATIVELYORNEGATIVELYAMEND,EXTENDORALTERTHECOVERAGEAFFORDEDBYTHEPOLICIES <br />BELOW.THISCERTIFICATEOFINSURANCEDOESNOTCONSTITUTEACONTRACTBETWEENTHEISSUINGINSURER(S),AUTHORIZED <br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br />IMPORTANT:IfthecertificateholderisanADDITIONALINSURED,thepolicy(ies)mustbeendorsed.IfSUBROGATIONISWAIVED,subjectto <br />thetermsandconditionsofthepolicy,certainpoliciesmayrequireanendorsement.Astatementonthiscertificatedoesnotconferrightstothe <br />certificate holder in lieu of such endorsement(s). <br />CONTACT <br />Jack Sharon or Lucy Holmes <br />PRODUCER <br />NAME: <br />The Insurance Center of Durham <br />FAX <br />PHONE <br />919-471-2541919-471-2132 <br />1920 Front St., Suite 710 <br />(A/C, No): <br />(A/C, No, Ext): <br />P. O. Box 15369 <br />E-MAIL <br />Lucy@insurancecenterofdurham.com <br />ADDRESS: <br />Durham, NC 27704- <br />PRODUCER <br />HAIGLE1 <br />Jack Sherron, CPCU <br />CUSTOMER ID #: <br />INSURER(S) AFFORDING COVERAGENAIC # <br />Scott Haigler Electric <br />Auto-Owners Insurance Co.18988 <br />INSURED <br />INSURER A : <br />6616 Blalock Road <br />Travelers Insurance Co. (AWC) <br />INSURER B : <br />Bahama, NC 27503 <br />INSURER C : <br />INSURER D : <br />INSURER E : <br />INSURER F : <br />COVERAGESCERTIFICATE NUMBER:REVISION NUMBER: <br />THISISTOCERTIFYTHATTHEPOLICIESOFINSURANCELISTEDBELOWHAVEBEENISSUEDTOTHEINSUREDNAMEDABOVEFORTHEPOLICYPERIOD <br />INDICATED.NOTWITHSTANDINGANYREQUIREMENT,TERMORCONDITIONOFANYCONTRACTOROTHERDOCUMENTWITHRESPECTTOWHICHTHIS <br />CERTIFICATEMAYBEISSUEDORMAYPERTAIN,THEINSURANCEAFFORDEDBYTHEPOLICIESDESCRIBEDHEREINISSUBJECTTOALLTHETERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />ADDLSUBR <br />POLICY EFFPOLICY EXP <br />INSR <br />TYPE OF INSURANCELIMITS <br />POLICY NUMBER <br />(MM/DD/YYYY)(MM/DD/YYYY) <br />LTR <br />INSRWVD <br />1,000,000 <br />GENERAL LIABILITY <br />EACH OCCURRENCE$ <br />DAMAGE TO RENTED <br />AX 35852991309/13/201409/13/2015 <br />100,000 <br />COMMERCIAL GENERAL LIABILITY$ <br />PREMISES (Ea occurrence) <br />X <br />5,000 <br />CLAIMS-MADEOCCURMED EXP (Any one person)$ <br />1,000,000 <br />PERSONAL & ADV INJURY$ <br />2,000,000 <br />GENERAL AGGREGATE$ <br />2,000,000 <br />GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ <br />PRO- <br />$ <br />POLICYLOC <br />JECT <br />COMBINED SINGLE LIMIT <br />AUTOMOBILE LIABILITY <br />$ <br />(Ea accident) <br />ANY AUTO <br />BODILY INJURY (Per person)$ <br />ALL OWNED AUTOS <br />BODILY INJURY (Per accident)$ <br />SCHEDULED AUTOS <br />PROPERTY DAMAGE <br />$ <br />(PER ACCIDENT) <br />HIRED AUTOS <br />$ <br />NON-OWNED AUTOS <br />$ <br />UMBRELLA LIAB <br />EACH OCCURRENCE$ <br />OCCUR <br />EXCESS LIAB <br />CLAIMS-MADEAGGREGATE$ <br />$ <br />DEDUCTIBLE <br />$ <br />RETENTION$ <br />WC STATU-OTH- <br />WORKERS COMPENSATION <br />X <br />TORY LIMITSER <br />AND EMPLOYERS' LIABILITY <br />Y / N <br />B 6JUB5033P6191502/04/201502/04/2016 <br />100,000 <br />ANY PROPRIETOR/PARTNER/EXECUTIVEE.L. EACH ACCIDENT$ <br />Y <br />N / A <br />OFFICER/MEMBER EXCLUDED? <br />100,000 <br />(Mandatory in NH) <br />E.L. DISEASE - EA EMPLOYEE$ <br />If yes, describe under <br />500,000 <br />E.L. DISEASE - POLICY LIMIT$ <br />DESCRIPTION OF OPERATIONS below <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br />ELECTRICIAN <br />CERTIFICATE HOLDERCANCELLATION <br />ORAN016 <br />SHOULDANYOFTHEABOVEDESCRIBEDPOLICIESBECANCELLEDBEFORE <br />THEEXPIRATIONDATETHEREOF,NOTICEWILLBEDELIVEREDIN <br />Orange County <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />P O Box 8181 <br />Hillsborough, NC 27278 <br />AUTHORIZED REPRESENTATIVE <br />Jack Sherron, CPCU <br />© 1988-2009 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2009/09)The ACORD name and logo are registered marks of ACORD <br />