2016-734-E AMS - Scott Haigler Electric DSS building

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DocuSign Envelope ID: D78897AD-7725-4356-86DA-680ODBOE8CC8 HAIGLE1 OP ID:C2 .ar �Rl1a' CERTIFICATE OF LIABILITY INSURANCE r7ATElMM1BDIYYYYJ 05/3112016 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 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 holder in lieu of such endorsements. PRODUCER CONTACT Brett Roberts __ The Insurance Center of Durham NAME. - PHONE Front St.,Suite 710 [,arc Nu,ExtI.919-471-2541 wC'Na),919-471-2132 P.O.Box 15369 E-MAIL Durham,NC 27704- ADDRESS: Brett Roberts INSURERS AFFORDING COVERAGE NAIC II _ _INSURER A:Auto-Owners Insurance Co. _ 18988 INSURED Scott Haigler Electric INSURER 5:Travelers Insurance-RMD AWC) 6616 Blalock Road _ - Bahama,NC 27503 INSURER C: - INSURER D: _ INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. ILTR TYPE OF INSURANCE POLICY NUMBER MMIDD AD LSUBR YIYYYY MMIDD EFF POLICY EY -_ LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,001] CLAIMS-MADE I X1 OCCUR 36852992-16 09/1312016 09113/2016 PREMISES. EaENTEORce S 5Q,00 i MED EXP(Any one parson) $ 5,00 _ PERSONAL&ADV INJURY $ 1,00(),00 GEN'L AGGREGATE eLIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- LOC PRODUCTS-COMPIOPAGG S 2,000,00 OTHER: S - - AUTOMOBILE LIABILITY COMBINEO SINGLE LIMIT $ Ea acddent _ ANY AUTO BODILY INJURY(Per person} $ ALL OWNED SCHEDULED BODILY INJURY Per accident) S AUTOS AUTOS ( r NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per acdde I S _ $ i -- UMBRELLA LIAR OCCUR EACH OCCURRENCE EXCESSLIAB HCLAIMS-MADE AGGREGATE_ $ DED RETENTION b WORKERS COMPENSATION PER TH- AND EMPLOYERS'LIABILITY _ STATUTE ER B ANY PROPRiETORIPARTNERIEXECUTIVE YIN GJUBSF9627316 02/20/2016 02/2012017 E.L,EACH ACCIDENT 3 1:OQQ,QQ OFFICERIMEMBER EXCLUDED? ❑NIA --- _ (Mandatary in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 IF es,describe under -_._, - D SCRIPTION OF OPERATIONS.below E.L.DISEASE-POLICY LIMIT $ 1,®OO,OQ DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(ACORD 1e1,Addllianal Remarks Schedule,may be attached it more space Is required) CERTIFICATE HOLDER CANCELLATION ASSE006 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Orange County Asset THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.. Management Services AUTHORIZED REPRESENTATIVE QQ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD