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DocuSign Envelope ID: BE59ABC9- A542 -42B5- 8112- B376B7580B9B <br />AC "ROB <br />CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MNIDOIYYYY) <br />I 47!1442[117 <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(ies) must have ADDITIONAL INSURED provisions or be endorsed. If <br />SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy, certain policies may require an endorsement. A statement on this <br />certificate does not confer rights to the certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />FEDERATED MUTUAL INSURANCE COMPANY <br />HOME OFFICE: P.O. BOX 328 <br />CONTACT <br />NAME: CLIENT CONTACT CENTER <br />A G,Na Ext : 888 -333 -4949 FAX No): 507 -446 -4664 <br />EMAIL <br />ADDRESS: CLIENTCONTACTCENTER FEDINS.COM <br />OWATONNA, MN 55060 <br />INSURERS) AFFORDING COVERAGE <br />NAIC 11 <br />07114/2018 <br />INSURER A: FEDERATED MUTUAL INSURANCE COMPANY <br />13935 <br />INSURED T�252-856 -0 <br />INSURER B: <br />HARRIS BROTHERS ELECTRIC AND CONTROLS, INC. <br />2712 HILLSBOROUGH RD <br />INSURER C- <br />N <br />INSURER D: <br />PERSONAL & ADV INJURY <br />DURHAM, NC 277053 -4044 <br />INSURER E: <br />GENERAL AGGREGATE <br />$2,000,000 <br />INSURER r- <br />$2,000,006 <br />COVERAGES CERTIFICATE NUMBER: 36 REVISION NUMBER: 1 <br />THIS IS TO CERTIFY" THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE ft ua _ 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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />DL <br />INSR <br />SUBR <br />WVd] <br />POLICY NUMBER <br />POLICY EFF <br />MMIDDIYYYY <br />POLICY EXP <br />UULRa YYYY <br />LIMITS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />CLAIMS -MADE X OCCUR <br />N <br />N <br />6048918 <br />0711412617 <br />07114/2018 <br />EACH OCCURRENCE <br />$1,006,600 <br />DAMAGE TO RENTED <br />P 15E5 Ea occurrence <br />$100,000 <br />M €D EXP (Any one person) <br />EXCLUDED <br />N <br />PERSONAL & ADV INJURY <br />$1,000,0001 <br />N'L AGGREGATE LIMIT APPLIES PER: <br />POLICY � JECT ❑ LOC <br />OTHER: <br />GENERAL AGGREGATE <br />$2,000,000 <br />PRODUCTS - COMPIOP AGG <br />$2,000,006 <br />A <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />SCHEDULED <br />OWNED AUTOS ONLY AUTOS <br />NON -OWNED <br />HIRED AUTOS ONLY AUTOS ONLY <br />N <br />N <br />6048918 <br />67/14/2617 <br />07/14/2018 <br />COMBINED SINGLE LIMIT <br />a accident <br />1,,666,666 <br />BODILY INJURY IPer person) <br />BODILY INJURY IPer accident) <br />PROPERTY DAMAGE <br />Per a. 'dais <br />A <br />X <br />UMBRELLA LIAR <br />EXCESS LIAR <br />X <br />OCCUR <br />CLAIMS-MADE <br />N <br />N <br />6648919 <br />07/14/2617 <br />07/1412018 <br />EACH OCCURRENCE <br />$5,000.,000 <br />AGGREGATE <br />$5,666,000 <br />DED I I RETENTION <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS" LIABILITY Y f N <br />ANY PROPRIETORMARTNERIEXECUTIVE <br />OFFICERIMEM13ER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe tinder <br />DESCRIPTION OF OPERATIONS below <br />NIA <br />N <br />6048920 <br />6711412017 <br />071141201.8 <br />X <br />PER STATUTE <br />OTH- <br />ER <br />€ -L. EACH ACCIDENT <br />$1,000,066 <br />E.L, DISEASE - EA. EMPLOYEE <br />1,006,666 <br />E.L DISEASE - POLICY LIMIT <br />$1,000,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES IACORD 101, Additional Remarks Schedule, may be attached It more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />252- 856 -0 361 <br />ORANGE COUNTY <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />PO BOX 8181 <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />HILLSBOROUGH, INC 27278 -8181 <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />0 1988 -2015 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD <br />