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DATE{MMIDDIYYYY) <br /> DocuSign Envelope ID: 989208CCx 1 irmom i r-60%7jF7F-3 wmBILITY INSURANCE 071D912015 <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 BELOW, THIS <br /> CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR <br /> PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(tes)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms <br /> and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder <br /> In lieu of such endorsement(s). <br /> PRODUCER CONTACT CLIENT CENTER <br /> FEDERATED MUTUAL INSURANCE COMPANY <br /> HOME OFFICE:P.O. BOX 328 A Cno,Ext:888-333-4949 A/C No):o: 507 46-4664 <br /> OWATONNA, MN 55060 AWDRIl Ss:CLIENTCONTACTCENTER FEDINS.COM <br /> INSURERS AFFORDING COVERAGE HAIC# <br /> INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 <br /> INSURED 252-856-0 INSURER B: <br /> HARRIS BROTHERS ELECTRIC AND CONTROLS INC INSURER C: <br /> 2712 HILLSBOROUGH RD <br /> DURHAM, NC 27705 INSURER D: <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:36 REVISION NUMBER:0 <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS <br /> AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> rA TYPE OF INSURANCE DL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> M f D MMfDDIYYYY <br /> GENERAL LIA131LITY EACH OCCURRENCE $1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PR AOE To(E. —RENTED $100,000 <br /> CLAIMS-MADE OCCUR MEO EXP(Any one person) EXCLUDED <br /> N N 0749677 07/14/2015 07/14/2016 PERSONAL&ADV INJURY $1,000,000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGO $2,000,000 <br /> X POLICY JECT LOC <br /> r <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 moh0o <br /> X ANY AUTO BODILY INJURY[Per person) <br /> ALL OWNED SCHEDULED <br /> A AUTOS AUTOS N N 0749677 07/14/2015 07/14/2016 BODILY INJURY(Per accident) <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE <br /> AUTOS Paracd <br /> X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 <br /> A EXCESS LIAB CLAIMS-MADE N N 0749678 07/14/2015 07/14/2016 AGGREGATE s5,000,000 <br /> DIED I I RETENTION <br /> WORKERS COMPENSATION X WCSTATU• OTH- <br /> AND EMPLOYERS'LIABILITY TORY LIMITS ER <br /> ANY PROPRIETORIPARTNERIEXECUTIVE Y❑ E.L.EACH ACCIDENT $1,OD0,000 <br /> A OFFICERIMEMBER EXCLUDED? NIA N 0749679 07/14/2015 07/14/2016 <br /> (Mandatory in NHI E.L.DISEASE•EA EMPLOYEE $1,000,000 <br /> It yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> 252-856-0 36 0 <br /> ORANGE COUNTY SHOULD ANY OF THE-ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> HILLSBOROUGH, NC 27278-8181 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE <br /> 0 1988-2010 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2010!05) The ACORD name and logo are registered marks of ACORD <br />