2017-714-E AMS - Harris Bros ATS switches

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DocuSign Envelope ID:5044C153-B8F0-49E9-9B25-B9349EC994DA DocuSign Envelope ID:98637986-D2B9-41A2-977B-F767CDAC7A6C Ac �� A CERTIFICATE OF LIABILITY INSURANCE 7/1DD�YYYY, D7114fZ017 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(Sy, 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 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 rl hts to the certificate holder in lieu of such endorsements, PRODUCER C014TACT FEDERATED MUTUAL INSURANCE COMPANY NAME: CLiE CCI rAX C C E HOME OFFICE:P.O.BOX 328 Afc,Nm Exl:888-3334949 (A/C,NO).507—46-4664 QWATONNA,IutN 55060 ADDRESS:CLIENTCONTACTCENTER(aFEDINS.CO_M_ _ INSURER Sp AFFORDING COVERAGE NAIL p INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 252-856-0 INSURER B:. HARRIS BROTHERS ELECTRIC AND CONTROLS,INC. INSURERc: 2712 HILLS130ROUGH RD DURHAM,NC 27705-4D44 INSURER D: 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 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 TYPE OF INSURANCE DL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INS WUO IDDIYYYY MMfDD1YYYY X COMMERCIALGENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE To RENTED CLAIMS-MADE X]OCCUR P E SES Eaoc ce $100,000 MED EXP(Any ono Person) EXCLUDED A N N 6048918 07/14/2017 0711412018 PERSONAL A ADV INJURY $1,000,000 OEWL AOGREOATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 x pOL1CY ❑JECT ❑LOC PRODUCTS.COMPIOP AOO $2,000,000 orHER: f AUTOMOBILE LIABILITY OM'81NED SINGLE LIMIT Ea acc dogo $1,000,000 I. X ANY AUTO BODILY INJURY(Per personi SCHEDULED OWNED AUTOS ONLY A AUTOS N N 6048918 0711412017 07114/2018 BODILY INJURY(Per accident} HIRED AUTOS ONLY NON OWNED PROPERTY DAMAGE AUTOS ONLY Weraccidnno x UMBRELLA LIAB X OCCUR EACH occURRENCE $5,000,000 A EXCESS LIAB cLAJMs•MADE N N SD48919 07/1412017 07/14/2018 AOORCOATE $51DD01000 DED I RETENTION WORKERS COMP£NSATiON 'X PER STATUTE ER- AND(EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE I E.L.EACH ACCIDENT $1,ODO,000 A oFncERIMEMBER EXCLUDED? I HIA N 6048920 07/14/2017 07/14/2018 - E.L DISEASE-EA EMPLOYE£_. (Mandatory In NH) $1,00,000 11 yes,describe under E,L DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS bNoW $1,ODO,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addldonal Remarks Schedule,may be attached iI more apace is required) CERTIFICATE HOLDER CANCELLATION 252-856-0 36 1 ORANGE COUNTY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 8181 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN H I LLSBOROUGH,NC 27278-8181 ACCORDANCE WITH THE POLICY PROVISIONS, j AUTHORIZED REPRESENTATIVE 0 19190-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD