2019-254-E Solid Waste - Evans Electric maintenance shop repair

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DocuSign Envelope ID:887CE981-F99A-4F1A-AA02-2748147OA8DD A1'�® CERTIFICATE OF LIABILITY INSURANCE DATE 018 12/14/2018 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. If SUBROGATION IS WAIVED, subject to the terns 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 endorsemen4 s. PRODUCER - - - --- CONTACT - _-- - FEDERATED MUTUAL INSURANCE COMPANY NAME: CLIENT CONTACT CENTER HOME OFFICE: P.O. BOX 328 A C,No Ext:888-333-4949 Aic No):507-446-4664 OWATONNA, MN 55060 E-MAIL ADDRESS:CLIENTCONTACTCENTER FEDINS.COM INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:FEDERATED MUTUAL INSURANCE COMPANY 13935 INSURED 352-548-2 INSURER B: D W EVANS ELECTRIC INC INSURER C: 3511 EVANS CORPORATE LN DURHAM, NC 27705-7981 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:85 a REVISION NUMBER:0 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRINSR WVD MM/DDIYY_YY _ _ M_MID_D/YYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 CLAIMS-MADE �OCCUR PREIMISES(AGE ToEa ocJ uErrrence) $100,000 MED EXP(Any one person) EXCLUDED A N N 9171304 07/01/2018 07/01/2019 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X SECT ❑LOC PRODUCTS-COMP/OP AGG $2,000,000 POLICY El OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 Ea accident X ANY AUTO BODILY INJURY(Per person) OWNED AUTOS ONLY SCHEDULED A AUTOS N N 9171304 07/01/2018 07/01/2019 BODILY INJURY(Per accident) HIRED AUTOS ONLY NON-OWNED PROPERTY DAMAGE AUTOS ONLY Per accident X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $8,000,000 A EXCESS LIAB CLAIMS-MADE N N 9171306 07/01/2018 07/01/2019 AGGREGATE $8,000,000 DED I I RETENTION WORKERS COMPENSATION OTH- AND EMPLOYERS'LIABILITY Y ST TE X PER ATU ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000 A OFFICER/MEMBER EXCLUDED? NIA N 9171307 07/01/2018 07/01/2019 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 352-548-2 85 0 ORANGE COUNTY SOLID WASTE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1514 EUBANKS RD THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CHAPEL HILL, NC 27516-8124 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE /, O 1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD