2016-522-E AMS - Harris Bros. Electric & Controls, Inc. for power for motorized gate

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DocuSign Envelope ID: 3318D9E2-B48D-40CD-8B0B-5952BB24E24B DocuSign Envelope ID:3318D9E2-1348D-40CD-8B0B-5952BB24E24B ,„,.......ft) 0 _ ACC#RD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDITYYY) I 9/8/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certfficate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and.conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement s) --, ....—...-- PRODUCER CONTAC Debby Blanchard rkicn.NNE.Q.je 0 Glick & Mahan Agency (336)228-0525 -7 FAX (336)229-0900 (NC,No); . 2326 South Church St. AED"M6ARIELasblanchd3@nationwide.com . Ste C INSURERS),AFFORDING COVERAGE Burlington NC 27215 INSURER A IDONEGAL INSURANCE GROUP 13692 INSURED INSURERS: HARRIS BROTHERS ELECTRIC AND CONTROLS INC INSURER C 2712 HILLSBOROUGH ROAD INSURER 0 INSURER S L _ DURHAM NC 27705 INSURER E COVERAGES CERTIFICATE NLIMBER:CL1672500409 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE I ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWIT HSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 10 WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMs, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS ......_,... _ pis R l'AUDL 0 POLICY EFF f POLIcY'EXP LTR TYPE OF INSURANCE I MI) wve POLICY NUMBER IMIIMIDEMYY)I IMM/OLVYTYY1 LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE I$ 1,000,000 1 I °MADE%MEMO 7 i CLAIMS-MADE I X OCCUR P_REMJESSIEjl.sza orrerc_o I $ 100,000 _ CPP8925539 07/14/2016 07/14/20171 MED EXP I/Intone person) $ 50000 --- A 11 PenspNAL&ACV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 2,000,000 2000,000- X POLICY! 78-1: 1 I LOC i PRODUCTS-COMP/OP AGG $ 1 - OTHER' $ AUTOMOBILE LIABILITY 1 COMBINED SINGLE LIMIT .. 1 000,000 ai sodderj) _.4 X ANY AUTO BODILY INJURY(Per person) $ — _ ALL OWNED - - SCHEDULED CA8925539 07/14/2016 07/14/2017 BODILY INJURY(Per accident) $ AUTOS AUTOS A , , NON OWNED PROPERTY DAMAO _ •••_ HIRED AUTOS •• AUTOS (psi acdden0 $ $ IX UMBRELLA LIAB X OCCUR 1•A EACH CCCURRENCE $ 5,.000 000_ EXCESS LIAB CLAIMS.MADE CX8925539 07/14/2016 07/14/2017 1 AGO REGATE $ 54 000,000 DE 0 j RETENTION $ ,-. WORKERS COMPENSATION , I PER , ' I OTH AND EMPLOYERS'LIABILITY ylw 1 " LETATWE IF& — ANY PROPRIETOR/PARTNER/EXECUTIVE [ j N/A WC8925539 07142016 07142017 EL.EACH ACCIDENT 1$ 1t000J/P00 OFFICERFMEMEIEli EXCLUDED? A mondeory an NH) E L DISEASE-EA EMPLOyE. $ 1000,00o If des cribo un der DESCRIPTION OF OPERATIONS below E L DISEASE-poucy LimiT $ 1,000,000 1 1 t DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached IT more space Is required) I . I CERTIFICATE HOLDER CANCELLATION abarnes@orangecountync.gov SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ORANGE COUNTY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 8181 ACCORDANCE WITH THE POLICY PROVISIONS, HILLSBOROUGH, NC 27278 AUTHORIZED REPRESENTATIVE 0 1942014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) 1