2019-067-E AMS - Harris Bros Eno Fire Dept shore line

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DocuSign Envelope ID: DD6426E6-FB6A-4F57-9462-CFFDBOA2838B '4 IY CERTIFICATE OF LIABILITY INSURANCE FDA,Ef1�DlYYYY, OB124I2D18 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 policyliesf 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 holder in lieu of such endorsements. PRODUCER CONTACT FEDERATED MUTUAL INSURANCE COMPANY NAME: C E CO C CE ER HOME OFFICE: P.D.BOX 328 aIIC w Ext:888-333-4949 All No:507�46�664 OWATONNA, MN 55060 E-MAIL ADDRESS:CLIENTCDNTACTCENTER FEDINS.COM _ INSURER(S)AFFORDING COVERAGE HAIG# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 252-856-0 INSURER B:FEDERATED SERVICE INSURANCE COMPANY 28304 HARRIS BROTHERS ELECTRIC AND CONTROLS, INC. INSURER C: 2712 HILLSBOROUGH RD DURHAM,NC 27705-4D44 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:35 REVISION NUMBER.4 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSR WVD MMIDDIYYYY MM;DDIYYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE — OCCUR PREMISES EaDcaEr ce $100,000 MED EXP(Any me person) $5,000 A Y N 6048918 07/14/2018 07/14/2019 PERSONAL&ADV INJURY $1,ODO,D00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2 000 000 X POLICY ❑JECT LOC PRODUCTS-COMPIOP AGO $2.DDO.DOD OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,DOD Ea a cid n X ANY AUTO BODILY INJURY{Per person) SCHEDULED OWNED AUTOS ONLY A AUTOS N N 6048918 07/14/2018 07/14/2019 BODILY INJURY{Per accident} HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY a acci n X UMBRELLA LIAB. X OCCUR EACH OCCURRENCE $5,000,00D A EXCESS LIAB CLAIMS-MADE N N 6048919 07/14/2018 07/14/2019 AGGREGATE $5,000,DOD DE❑ I I RETENTION WORKERS COMPENSATION OTH- Y!N AND EMPLOYERS'LIABILITY X PER STATUTE ER ANY PROPRIETORIPARTNEWEXECUTIVE E.L.EACH ACCIDENT $1,ODO,DDD B OFFICERIMEMBER EXCLUDED? NIA N 604-8920 07/14/2018 0711412D19 (Mandatory in NHJ E.L.DISEASE-EA EMPLOYEE $1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,DOD,00" DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached iI more space is required) THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE CONDITIONS OF THE ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - AUTOMATIC STATUS WHEN REQUIRED IN CONSTRUCTION AGREEMENT WITH YOU ENDORSEMENT FOR GENERAL LIABILITY. CERTIFICATE HOLDER CANCELLATION 252-856-0 364 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 (D 1988-2U15 ACORD CORPORATION.All rights reserved. ACORD 25(2DI6/03) The ACORD name and logo are registered marks of ACORD