2018-045-E AMS - Harris Bros Electric and Controls install circuit and breaker lock

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DocuSign Envelope ID: 52A49306- C416- 4C8C- BE2F- 5CDE93DAED71 A °QO CERTIFICATE OF LIABILITY INSURANCE DATE 07 /14 7/1412tiD/ 17 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 certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or he 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 endorsements . PRODUCER. FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE: P.O. BOX 328 CONTACT ME: CLIENT CONTACT CENTER PHONE I FAX AA/c, No Ext : 888-333 -4949 AIC No): 507- 446 -4564 E-MAIL ADDRESS: CLIENTCONTACTCENTER FEDINS.COM OW'UATONNA, MN 55060 INSURER(S) AFFORDING COVERAGE NAIL # r0711'412017 INSURER A: FEDERATED MUTUAL INSURANCE COMPANY 13935 $1,000,000 INSURED 252_856 -0 INSURER B: $1000 HARRIS BROTHERS ELECTRIC AND CONTROLS, INC. INSURER C: EXCLUDED 2712 HILLSBOROUGH RD INSURER D. PERSONAL & ADV INJURY DURHAM, NC 27705 -4044 INSURER E: GENERAL AGGREGATE $2,000,000 INSURER F: $2,000,000 COVERAGES CERTIFICATE NUMBER: 36 REVISION NUMBER: 1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO 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. INSR LTR TYPE OF INSURANCE DDL INSR SUER WVD POLICY NUMBER LCY EFF DDdYYYY POLICY EXP MMlDDdYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR N N 6048918 r0711'412017 07/14/2018 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED P E S a currence $1000 MED EXP lAny one person) EXCLUDED GEN'L X PERSONAL & ADV INJURY $1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY � JECT F L8C OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMPIOP A430 $2,000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS HIRED AUTOS ONLY NON -OWNED AUTOS ONLY N N 6048918 07/14/2017 07/1412018 COMBINED SINGLE LIMIT Ea acciden9 X1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident] PROPERTY DAMAGE jftr acciden • X UMBRELLA LIAB EXCESS LIAR X OCCUR CLAIMS -MADE N N 6048919 07114/2017 07/14/2018 EACH OCCURRENCE $5,00'0,01)0 AGGREGATE $5,000,000 QED I I RETENTION • WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatary in NHI It yes, describe under DESCRIPTION OF OPERATIONS below N d A N 6048920 07/14/2017 07/14/2018 X PER STATUTE OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L DISEASE - POLICY OMIT $1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS d VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached II more space IS required) CERTIFICATE HOLDER CANCELLATION 252 -856 -0 361 ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HILLSBOROUGH, NC 27278 -8181 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Q 1988 -2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD