2018-728-E AMS - Sportsplex Boiler Replacement

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DocuSign Envelope ID:6B7A77DD-54E7-4F47-B9AO-DD965DOE64AD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 04/1712018 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 be endorsed, It 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 canter rights to the certificate holder in lieu of such endorsements, PRODUCER NAME CT CLIENT CONTACT CENTER FEDERATED MUTUAL INSURANCE COMPANY HOME OFFICE:P.O.SOX 328 IAICNNo Exa:488-333-4949 (A N.):507446-4664 OWATQNNA,MN 55060 ADDRESS:CLiENTCONTACTCENTER FEDINS.COM INSURER S) AFFORDING COVERAGE HAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 348-705-5 INSURER B: TRADEMASTERS SERVICES INCORPORATED INSURER C: 5012 NEAL RD DURHAM, NC 27705-2362 INSURER D: $USURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:34 REVISION NUMBER:2 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 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 SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS LT INSR WVD MMIDDIYYYY MMIDDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED $100,000 CLAIMS-MADE I OCCUR 5 s e oc ace MED EXP(Any one person) EXCLUDED A Y N 9337203 02111/2018 02111/2019 PERSONAL&ADV INJURY $1,GOD,000 OEN'L AGGREGATE"MIT APPLIES PER: GENERAL AGGREGATE $2,0120,000 PRO- M POLICY 1:1 OTHER: LOC PRODUCTS-COMPIOP AGO OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 We accident X ANY AUTO BODILY INJURY(Per person) 1{ OWNED AUTOS ONLY AUTOSUL£D Y N 9337203 02/11/2018 021111201$ BODILY INJURY IPer acciden¢ HIRED AUTOS ONLY NON OWNED P Per ROPERTY DAMAGE AUTOS ONLY acdden X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $5,000,000 A EXCESS LIAR CLAIMS-MADE N N 9337204 02/11/2014 0211912019 AGGREGATE $5,000,000 DED I I RETENTION WORKERS COMPENSATION OT - AND EMPLOYERS'LIABILITY YIN X PER STATUTE H ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $1,000,000 A OFrICERFMEMBER EXCLUDED? NIA N 9337205 02/11/2018 02/1112019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,(00,00 If yes,describe under E.L DISEASE-.POLICY LIMIT DESCRIPTION OF OPERATIONS below $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Addillonal Remarks Schedule,may be attachod if more space Is requiredl SEE ATTACHED PAGE i I CERTIFICATE HOLDER CANCELLATION 348-705-5 34 2 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 ID 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD