2017-699-E AMS - Harris Bros Whitted ATS panel

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DocuSign Envelope ID: 150FAC57-4891-47F3-9504-4284DB66973C DocuSign Envelope ID:98637986-D2B9-41A2-977B-F767CDA07A6C AC R" DATE IMMMDNYYY] +� CERTIFICATE OF LIABILITY INSURANCE 07/14/2017 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(les} must have ADDITIONAL INSURED provisions or 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 nut confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY nA. CLIENT CONTACT.CENTER PAX HOME OFFICE: P.O.BOX 328 cNrEI4 ExI):888-333-4949 tA IC Nd 1 507-446A664 OWATONNA,MN 55064 AMD DAR Ess:CLIENTCONTACTCENTER FFDINS.COM INSURERS AFFORDING COVERAGE NAIL# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 252-856-0 INSURER B: ~ HARRIS BROTHERS ELECTRIC AND CONTROLS,INC. INSURER C- 2712 HILLSBOROUGH RD DURHAM,NC 27705-4044 INSURER DI INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:36 REVISION NUMBER:1 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE Ikz..ti _ 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. NT R TYPE OF INSURANCE NSR WBR POLICY NUMBER POLICY E£F POLICY EXP LTR iN5 WVD AIMIDDIYYYY Mh4wDlyYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 51,000,000 CLAMS°MAO€ 1XI OCCUR DAMAGE TO RENTED $100,0{]0 PRCM SSS Ea ocutrrEno)_ _ MED EXP(Any one person) EXCLUDED A N N 6048918 0711412017 07114/2018 PERSONAL ADV INJURY $1,000,000 GEH'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000 Q00 POLICY E JECT 0 LOc PRODUCTS-COMPIOP AGO $2,00,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,x,00(} X ANY AUTO BODILY INJURY(Per person) A OWNED AUTOS ONLY AUTOSUL€D N N 6048918 0711412017 071141208 BODILY INJURY(Per accident] HIRED AUTOS ONLY NON-OWNED AUTOS ONLY PROPERTY DAMAGE LPor acrl den X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAR CLAIMS•MADE N N 6048919 07/14/2017 07/1412018 AGOAEOATE $5,000,000 DED RETENTION WORKERS COMPENSATION 7711. YIN AND EMPLOYERS'LIABILITY X PER STATUTE ER ANY PROPRIETORfPARTNERIEXECUTNE E.L.EACH ACCIDENT $1000000 A OFFICERIMEMBER EXCLUDED? NIA N 6046920 07!1412017 07/14/2018 —--- $1,000,000 In NH E.L.DISEASE-EA EMPLOYEE $1,000,000 N yes,doscrthe under DESCRIPTION OF OPERATIONS below El DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES jACORD 151,Addllional RemBrks Schedule,may be altadted it 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 ® 1980.2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD