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DocuSign Envelope ID: 75693651-8CDD-4BC3-B32F-F46CD5C2FD4B
<br /> --i3�IE�(MM/=YYYY-
<br /> ACC>RfY YY)
<br /> CERTIFICATE OF LIABILITY INSURANCE "'YY
<br /> 11111 71/2015 F 5/(,f2(}1.5
<br /> m '
<br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
<br /> the terms and conditions of the Policy,certain Policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement(s).
<br /> CQACT
<br /> PRODUCER LOCKTON COMPANIES N 09, All
<br /> 2 100 ROSS AVENUE,SUITE 1400 (PAr Ne,ExtIL IFA,C,No):
<br /> DALLAS,TX 75201 E-MAIL
<br /> 214-969-6700 AUDIRLS& I
<br /> INAWMR15)AEEQRDINQ�QQVERAQL NAIC
<br /> INSURER A: Federal Insurance Company 20281
<br /> rNsuRED Door Services Corporation INSURER B:: Ironshore Specialty Insurance Co 25445
<br /> 1342188 dba Advanced Door Automation iNsuRER C Mitsui SunI Insurance Co ol'America 20362
<br /> PO Box 61678
<br /> Durham NO 27715 -MSUREa Q Chubb lndemnI! Insurance Company 12777
<br /> INSURER E
<br /> INSURER F
<br /> COVERAGES, OVEDOO I CERTIFICATE NUMBER: 13473293 REVISION NUMBER: XXXXXXX
<br /> THIS IS 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> INDICATED.NOTWITHs,rANDING ANY REQUIREMENT,TERM OR CONDIVON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH PHIS
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> TYPE OF INSURANCE ADDL, POLICY NUMBER LIMITS
<br /> fiso VM IIQMYE)ffy�Im"'Mohilcow0py
<br /> C X COMMERCIAL GENERAL LIABILITY Y N GI,2122489 1 W 1 14 10/112015 EACH(XCURRENCE 2,000,000
<br /> OCCUR A AGE To RE 1,000,000
<br /> MISL
<br /> CLAIMS-MADE rX I FIRM =S IE.r rcoi
<br /> X. SIR apphe�jvr MEDEXP An one person� 10.000
<br /> pi2lic),uum&'cond- PERSONAL&ADV INJURY s 10001000
<br /> GEN'L AGGREGATE UM IT APPLIES PER: GENERAL 4GGREGATE s 4,000,000
<br /> PR O,
<br /> POUCYE-1 JECT F-1 Lrx: PRODUCTS-CGMP;0P AGO $ 4.000 000
<br /> OTHER $
<br /> A AUTOMOBILE LIABILITY N N 73570693 10/1�12014 10/1/20 15 IC SINGLE LIMIT
<br /> EqMRINEI'l SING
<br /> .. �Oe'tl s 1,000.000
<br /> X ANY AVTO BODILY VNJURY lPer person) $ XXXXXXX
<br /> ALL HEDULED
<br /> U78WNEO BODILY INJURY IPer accdent $ XXXXXXX
<br /> A S AUTOS
<br /> I-IREDAUTO X NRrN
<br /> WNED PROP TY DAwoaGE
<br /> $ XXXXXXX
<br /> iPer acc4denfi
<br /> $ XXXXXXX
<br /> B X UMBRELLA LAB X OCCUR N N 001165903 10/1/2014 110/1,12015 EACH OCCURRENCE $ 10,000,000
<br /> EXCESS LIAR 1CLAIM5-MADE AGGREGATE. S 1()000,0'00
<br /> or-o I X I RETENTION$W,000 S XXXXXXX
<br /> A WORKERS COMPENSATION 1/2015 'RT-T I JOTH-
<br /> AND EMPLOYERS'LIABILITY YIN N 71740814(AOS 10/l/2014 TO/ E
<br /> D 0MCERIMEMSER EXKUMI 71747712 (MA,6 10/1/2014 E� EATIPACCIDENT S 1,000,000
<br /> ANY PF40P',RWI0rWAA I&WFxMPTNE
<br /> rm-d.I.ry 1.NH) FN N)A
<br /> T" I J)00.000
<br /> U"s,d—�6�4-dDPF
<br /> F JF'T R
<br /> "9"I . 0,OPFIR TIONS LWow E L DISEASE PrIL ICY LIMIT 1-000-0(:10
<br /> A Ewts�,Wwkers N N 71747695 (011) 7/1,�2014 7/1/20 15 WC swiuunv 1-11IMS
<br /> Comperminer(OH) $1,000,000LIA�ach Acx,dew
<br /> S,1,000MI0 EL 5scase Ernp/TI
<br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,AddMonal Remarks Schedule,may be attached if mom space is required)
<br /> CERTIFICATE HOLDER CANCELLATION See Attachment
<br /> SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 13473293 AUTHORIZED REPRESENTATIVE
<br /> Orange County
<br /> PO Box 8181
<br /> H01sborough NC 27278
<br /> ACORD 25(2014101) @1988-2014 ACORD CORPORATION.AIII rights reserved
<br /> The ACORD name and logo are registered marks of ACORD
<br />
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