2018-678-E AMS - Harris Bros Link outlet

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DocuSign Envelope ID:Al FDE49E-4292-4DD7-8013-79BFF5D80E77 DocuSign Envelope ID:46EAC4FA-7089-4504-ADA1-480BF2799823 '�� CERTIFICATE OAF LIABILITY INSURANCE DATEIMMIRDIYY55) 4s124, 41s 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 BETW€E14 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 not confer rights to the certificate holier In lieu of such endarsemen#s, PRODUCER Na ATE CT CLIENT CONTACT CENIER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE,P.O.BOX 328 PHONE r , Ekt:888-333-4949 p/e_NoI:507-4464664 �— OWATONNA,MN 55060 ADDRESS;CLIE TCONTACTCENTER FECSI S CO INSURER 5 AFFORDING COVERAGE NAIL II INSURER A;FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 252-856-4 INSURER B:FEDERATED SERVICE INSURANCE COMPANY 28304 HARRIS BROTHERS ELECTRIC AND CONTROLS,INC. HI SURER C: 2712 HILLSBOROUGH RD DURHAM,NC 27705-4444 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER.36 REVISION NUMBER:D THIS IS To CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED 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 13 SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE AnDt SURR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR NSR YND MM1DD1 YY MWDD1YY Y X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE �OCCUR DAMAGE STO Roc�cO a ca $100,000 MED EXP tAny one person) $5,000 A N N 644$918 0711472018 07114/2019 PERSONAL&ADV INJURY $1,000,000 OE 'LAGOREGATE LIMrr APPLIES PER: GENERAL AGGREOATE $2,000,000 X POLICY ❑JECT LOC PRODUCTS-COMPIOP AGO $2:000,000 JECT OTHER; AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 COT acc da I X ANY AUTO BODILY INJURY(Per person) OWNED AUTOS ONLY AUTOS LED A AUTOS N N 604$918 07114/2018 07114/2019 BODILY INJURY iParacclden� H @RED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY Per accid X UMBRELLA LIAR )( OCCUR EACH OCCURRENCE $5,00D,000 A EXCESS LIAD CLAIMS-MADE N N 6048919 07/1412018 0711412019 AGGREGATE $5,000,000 DEO RETENTION WORKERS COMPENSATION _X PER STATUTE ¢R AND EMPLoYERS'LIABILITY Y I N ANY PROPRIEToRIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,004,444 13 OFPICERIMEMBER EXCLUDED? NIA N 6048920 07/14/2018 07/1472019 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1,000,004 It yes,destribe sunder ELL DISEASE-POLICY LIMIT DESCRIPTION OF OPERATIONS below $1,444,400 I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 161,Addidonal Remarks Schedule,may ba aRached if more space is required) CERTIFICATE HOLDER CANCELLATION 252-$56-0 36 0 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 REPRESENT,4TtVE V I D 19HR-2015 ACORD CORPORATION.Alt rights reserved. ACORD 26(2016103) The ACORD name and logo are registered marks of ACORD